Keite da Silva Nogueira1, Maria Cristina Paganini2, Andréia Conte3, Laura Lúcia Cogo2, Iara Taborda de Messias Reason1, Márcio José da Silva4, Libera Maria Dalla-Costa5. 1. Clinics Hospital, Federal University of Paraná (UFPR), Curitiba, Brazil; Postgraduate Program in Pharmaceutical Sciences of UFPR, Curitiba, Brazil. 2. Clinics Hospital, Federal University of Paraná (UFPR), Curitiba, Brazil. 3. Medical Course of UFPR, Curitiba, Brazil. 4. Plant Molecular Biology and Genomics of Campinas University (Unicamp), Campinas, Brazil. 5. Clinics Hospital, Federal University of Paraná (UFPR), Curitiba, Brazil; Pelé Pequeno Príncipe Faculty and Research Institute (FPP/IPPPP), Curitiba, Brazil. Electronic address: lmdc@ufpr.br.
Abstract
BACKGROUND: Extended-spectrum β-lactamases (ESBLs) are increasingly prevalent in Enterobacter spp., posing a challenge to the treatment of infections caused by this microorganism. The purpose of this retrospective study was to evaluate the prevalence, risk factors, and clinical outcomes of inpatients with bacteremia caused by ESBL and non ESBL-producing Enterobacter spp. in a tertiary hospital over the period 2004-2008. METHODS: The presence of blaCTX-M, blaTEM, blaSHV, and blaPER genes was detected by polymerase chain reaction (PCR) and nucleotide sequence analysis. Genetic similarity between strains was defined by pulsed-field gel electrophoresis (PFGE). RESULTS: Enterobacter spp. was identified in 205 of 4907 of the patients who had positive blood cultures during hospitalization. Of those cases, 41 (20%) were ESBL-producing Enterobacter spp. Nosocomial pneumonia was the main source of bacteremia caused by ESBL-producing Enterobacter spp. The presence of this microorganism was associated with longer hospital stays. The ESBL genes detected were: CTX-M-2 (23), CTX-M-59 (10), CTX-M-15 (1), SHV-12 (5), and PER-2 (2). While Enterobacter aerogenes strains showed mainly a clonal profile, Enterobacter cloacae strains were polyclonal. CONCLUSION: Although no difference in clinical outcomes was observed between patients with infections by ESBL-producing and non-ESBL-producing strains, the detection of ESBL in Enterobacter spp. resulted in the change of antimicrobials in 75% of cases, having important implications in the decision-making regarding adequate antimicrobial therapy.
BACKGROUND: Extended-spectrum β-lactamases (ESBLs) are increasingly prevalent in Enterobacter spp., posing a challenge to the treatment of infections caused by this microorganism. The purpose of this retrospective study was to evaluate the prevalence, risk factors, and clinical outcomes of inpatients with bacteremia caused by ESBL and non ESBL-producing Enterobacter spp. in a tertiary hospital over the period 2004-2008. METHODS: The presence of blaCTX-M, blaTEM, blaSHV, and blaPER genes was detected by polymerase chain reaction (PCR) and nucleotide sequence analysis. Genetic similarity between strains was defined by pulsed-field gel electrophoresis (PFGE). RESULTS:Enterobacter spp. was identified in 205 of 4907 of the patients who had positive blood cultures during hospitalization. Of those cases, 41 (20%) were ESBL-producing Enterobacter spp. Nosocomial pneumonia was the main source of bacteremia caused by ESBL-producing Enterobacter spp. The presence of this microorganism was associated with longer hospital stays. The ESBL genes detected were: CTX-M-2 (23), CTX-M-59 (10), CTX-M-15 (1), SHV-12 (5), and PER-2 (2). While Enterobacter aerogenes strains showed mainly a clonal profile, Enterobacter cloacae strains were polyclonal. CONCLUSION: Although no difference in clinical outcomes was observed between patients with infections by ESBL-producing and non-ESBL-producing strains, the detection of ESBL in Enterobacter spp. resulted in the change of antimicrobials in 75% of cases, having important implications in the decision-making regarding adequate antimicrobial therapy.
Authors: Ana Laura Grazziotin; Newton M Vidal; Jussara K Palmeiro; Libera Maria Dalla-Costa; Thiago M Venancio Journal: Front Microbiol Date: 2016-10-27 Impact factor: 5.640
Authors: Jussara Kasuko Palmeiro; Robson Francisco de Souza; Marcos André Schörner; Hemanoel Passarelli-Araujo; Ana Laura Grazziotin; Newton Medeiros Vidal; Thiago Motta Venancio; Libera Maria Dalla-Costa Journal: Front Microbiol Date: 2019-07-23 Impact factor: 5.640