Detecção molecular do gene blaKPC em Klebsiella pneumoniae

Abstract

Klebsiella pneumoniae belongs to the family Enterobacteriaceae and has emerged as an opportunistic pathogen, capable of developing infections acquired in hospital environments. KPC-types carbapenemase enzymes are frequently found in enterobacteria and represents a serious problem by inhibiting the action of carbapenem antibiotics, cephalosporins and monobactams, reducing the therapeutic options and increasing the rate of nosocomial infections. With the emergence of several outbreaks of nosocomial infection caused by KPC, it began to compose an important mechanism of resistance in the context of hospital infection worldwide and research has become an important factor to restrict spread. This study aimed to characterize KPC-producing Klebsiella pneumoniae strains isolated from patients at the Public Hospital in Dourados/MS. The strains of K. pneumoniae were collected from February 2012 to April 2013. Strains with a carbapenem intermediate or resistant profile were submitted to Modified Hodge Test. The evaluation of the susceptibility profile to carbapenem was evaluated by Minimum Inhibitory Concentration (MIC), using the antibiotics meropenem, imipenem and ertapenem. The assessment of blaKPC-2 gene was performed using Polymerase Chain Reaction (PCR). In this study, 59 K. pneumoniae strains were isolated, mainly from samples of urine culture, rectal swab and tracheal secretion. These strains were tested in Modified Hodge Test and 97% were positive. In the determination of the MIC, 87% of these strains were resistant to the antibiotic imipenem, 93% to meropenem and 98% to ertapenem. When the 59 strains were assessed in PCR for blaKPC-2 gene, 83% showed positive results. These results show the high prevalence of KPC-producing K. pneumoniae strains in the Public Hospital in Dourados/MS. We believe that these results will contribute to preventive actions in the control of hospital infections caused by multidrug-resistant microorganisms of clinical interest.