AUTHOR=Ferreira Roumayne L. , da Silva Brenda C. M. , Rezende Graziela S. , Nakamura-Silva Rafael , Pitondo-Silva André , Campanini Emeline Boni , Brito Márcia C. A. , da Silva Eulália M. L. , Freire Caio César de Melo , Cunha Anderson F. da , Pranchevicius Maria-Cristina da Silva 

TITLE=High Prevalence of Multidrug-Resistant Klebsiella pneumoniae Harboring Several Virulence and β-Lactamase Encoding Genes in a Brazilian Intensive Care Unit

JOURNAL=Frontiers in Microbiology

VOLUME=9

YEAR=2019

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2018.03198

DOI=10.3389/fmicb.2018.03198

ISSN=1664-302X

ABSTRACT=<p><italic>Klebsiella pneumoniae</italic> is an important opportunistic pathogen that commonly causes nosocomial infections and contributes to substantial morbidity and mortality. We sought to investigate the antibiotic resistance profile, pathogenic potential and the clonal relationships between <italic>K. pneumoniae</italic> (<italic>n</italic> = 25) isolated from patients and sources at a tertiary care hospital’s intensive care units (ICUs) in the northern region of Brazil. Most of <italic>K. pneumoniae</italic> isolates (<italic>n</italic> = 21, 84%) were classified as multidrug resistant (MDR) with high-level resistance to β-lactams, aminoglycosides, quinolones, tigecycline, and colistin. All the 25 isolates presented extended-spectrum beta-lactamase-producing (ESBL), including carbapenemase producers, and carried the <italic>bla</italic><sub>KPC</sub> (100%), <italic>bla</italic><sub>TEM</sub> (100%), <italic>bla</italic><sub>SHV</sub> variants (<italic>n</italic> = 24, 96%), <italic>bla</italic><sub>OXA-1</sub> group (<italic>n</italic> = 21, 84%) and <italic>bla</italic><sub>CTX-M-1</sub> group (<italic>n</italic> = 18, 72%) genes. The K2 serotype was found in 4% (<italic>n</italic> = 1) of the isolates, and the K1 was not detected. The virulence-associated genes found among the 25 isolates were <italic>mrk</italic>D (<italic>n</italic> = 24, 96%), <italic>fim</italic>H-1 (<italic>n</italic> = 22, 88%), <italic>ent</italic>B (100%), <italic>iut</italic>A (<italic>n</italic> = 10, 40%), <italic>ybt</italic>S (<italic>n</italic> = 15, 60%). The genes related with efflux pumps and outer membrane porins found were <italic>AcrAB</italic> (100%), <italic>tol</italic>C (<italic>n</italic> = 24, 96%), <italic>mdt</italic>K (<italic>n</italic> = 22, 88%), <italic>Omp</italic>K35 (<italic>n</italic> = 15, 60%), and <italic>Omp</italic>K36 (<italic>n</italic> = 7, 28%). ERIC-PCR was employed to determine the clonal relationship between the different isolated strains. The obtained ERIC-PCR patterns revealed that the similarity between isolates was above 70%. To determine the sequence types (STs) a multilocus sequence typing (MLST) assay was used. The results indicated the presence of high-risk international clones among the isolates. In our study, the wide variety of MDR <italic>K. pneumoniae</italic> harboring β-lactams and virulence genes strongly suggest a necessity for the implementation of effective strategies to prevent and control the spread of antibiotic resistant infections.</p>