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Diagn Microbiol Infect Dis. 2015 Aug;82(4):326-30. doi: 10.1016/j.diagmicrobio.2015.04.002. Epub 2015 Apr 16.

Molecular epidemiology of KPC-2-producing Enterobacteriaceae (non-Klebsiella pneumoniae) isolated from Brazil.

Author information

1
Laboratório de Pesquisa em Infecção Hospitalar, Oswaldo Cruz Institute, RJ, Brazil.
2
Departamento de Microbiologia e Imunologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, RJ, Brazil.
3
Laboratório Central de Saúde Pública do Distrito Federal, DF, Brazil.
4
Laboratório Central de Saúde Pública do Espírito Santo, ES, Brazil.
5
Laboratório Central de Saúde Pública de Goiás, GO, Brazil.
6
Laboratório Central de Saúde Pública de Minas Gerais, MG, Brazil.
7
Laboratório de Pesquisa em Infecção Hospitalar, Oswaldo Cruz Institute, RJ, Brazil. Electronic address: anapdca@ioc.fiocruz.br.

Abstract

In Brazil, since 2009, there has been an ever increasing widespread of the bla(KPC-2) gene, mainly in Klebsiella pneumoniae. This study aims to assess the molecular epidemiology and genetic background of this gene in Enterobacteriaceae (non-K. pneumoniae) species from 9 Brazilian states between 2009 and 2011. Three hundred eighty-seven isolates were analyzed exhibiting nonsusceptibility to carbapenems, in which the bla(KPC-2) gene was detected in 21.4%. By disk diffusion and E-test, these isolates exhibited high rates of resistance to most of the antimicrobials tested, including tigecycline (45.6% nonsusceptible) and polymyxin B (16.5%), the most resistant species being Enterobacter aerogenes and Enterobacter cloacae. We found great clonal diversity and a variety of bla(KPC-2)-carrying plasmids, all of them exhibiting a partial Tn4401 structure. Therefore, this study demonstrates the dissemination of KPC-2 in 9 Enterobacteriaceae species, including species that were not previously described such as Pantoea agglomerans and Providencia stuartii.

KEYWORDS:

Carbapenem resistance; Enterobacteriaceae; KPC; Tn4401

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