Intrahospital spread of carbapenem-resistant Pseudomonas aeruginosa in a University Hospital in Florianópolis, Santa Catarina, Brazil Disseminação Intrahospitalar de Pseudomonas aeruginosa em Hospital Universitário de Florianópolis, Santa Catarina, Brasil

• Published in: Revista da Sociedade Brasileira de Medicina Tropical
• Main Authors: Mara Cristina Scheffer, Maria Luiza Bazzo, Mario Steindel, Ana Lucia Darini, Eduardo Clímaco, Libera Maria Dalla-Costa
• Format: Article in Journal/Newspaper
• Language: English
• Published: Sociedade Brasileira de Medicina Tropical (SBMT) 2010
• Subjects: Pseudomonas aeruginosa; Resistência aos carbapenêmicos; Infecção nosocomial; Carbapenem resistance; Nosocomial infections; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1590/S0037-86822010000400006; https://doaj.org/article/f298c2ec54c84e47977a813d03400f73

INTRODUCTION: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) has been isolated with increasing frequency in Brazilian hospitals. Since June 2003, its detection in a teaching hospital in the city of Florianópolis, Brazil, has increased. This study aimed to investigate the minimal inhibitory concentration (MIC), presence of Metallo-β-lactamase (MβL) and a possible clonal relationship among the isolates. METHODS: The study included 29 CRPA and seven isolates with reduced susceptibility. The MIC was determined by agar-dilution. Detection of MβL was performed by Double Disk Sinergism (DDS) and Combined Disk (CD). The MβL gene was verified by PCR and nucleotide sequence analysis. Epidemiological typing was performed by pulsed-field gel electrophoresis. RESULTS: Among the 29 carbapenem-resistant isolates, polymyxin B presented 100% susceptibility and piperacillin/tazobactam 96.7%. Seventeen (62%) strains were verified as clonal (A clone) and among these, six isolates indicated phenotypically positive tests for MβL and harbored the blaSPM-1 gene. The first CRPA isolates were unrelated to clone A, harbored blaIMP-16 and were phenotypically positive only by CD. CONCLUSIONS: The spread of a high-level of resistance clone suggests cross transmission as an important dissemination mechanism and has contributed to the increased rate of resistance to carbapenems. This study emphasizes the need for continuous surveillance and improved strategies. INTRODUÇÃO: O isolamento de Pseudomonas aeruginosa resistente aos carbapenêmicos (PARC) tem sido cada vez mais frequente nos hospitais brasileiros. O presente estudo investigou a concentração inibitória mínina (CIM), a presença de metalo-β-lactamases (MβL), e uma possível relação clonal entre PARC isoladas entre junho de 2003 a junho de 2005, em um hospital escola na cidade de Florianópolis, Brasil. MÉTODOS: O estudo incluiu 29 PARC e sete isolados com suscetibilidade reduzida. A CIM foi determinada por diluição em ágar. A detecção de MβL foi realizada por sinergismo de duplo disco ...