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JAC Advance Access published online on November 20, 2008
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkn484
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Original research

Carbapenem-hydrolysing β-lactamase KPC-2 in Klebsiella pneumoniae isolated in Rio de Janeiro, Brazil

Gisele Peirano1,*, Liliane M. Seki1, Vera Lúcia Val Passos2, Maria Cristina F. G. Pinto3, Lília R. Guerra3 and Marise D. Asensi1

1 Oswaldo Cruz Institute, Avenida Brasil 4365, 21040-360 Rio de Janeiro, Brazil 2 Hospital Geral de Bonsucesso (HGB), Avenida Londres 616, 21041-030 Rio de Janeiro, Brazil 3 Hospital Universitário Antônio Pedro (HUAP)—Universidade Federal Fluminense, Rua Marquês de Paraná 303, 24033-900 Niterói, Brazil

Received 17 July 2008; returned 27 August 2008; revised 30 October 2008; accepted 31 October 2008

* Corresponding author. Tel: +55-21-2598-4277, ext. 319; Fax: +55-21-2270-6565; E-mail: peirano{at}ioc.fiocruz.br

Objectives: The aim of this study was to characterize the KPC-type carbapenem-hydrolysing β-lactamase, extended-spectrum β-lactamases (ESBLs) and class 1 integrons among nosocomial Klebsiella pneumoniae isolated in Rio de Janeiro, Brazil.

Methods: MICs were determined and isolates were screened for ESBLs, metallo-β-lactamases (MBLs) and class A carbapenemase-producing phenotypes. The main β-lactamases resistance genes (blaTEM, blaSHV, blaCTX-M, blaKPC, blaIMP and blaVIM) and class 1 integrons were detected by PCR followed by DNA sequencing. The genetic relatedness of isolates was determined by PFGE.

Results: All K. pneumoniae isolates were positive for ESBL and class A carbapenemase production and negative for MBL production. All isolates were resistant to all β-lactam antibiotics, ciprofloxacin and gentamicin, being susceptible only to tigecycline and polymyxin B. The blaKPC-2, blaCTX-M-1, blaCTX-M-2, blaCTX-M-8 and blaSHV-11 genes were detected. PFGE analysis revealed two clonal types among KPC-producing isolates, both identified in the same hospital.

Conclusions: Our findings should alert medical authorities to implement stringent methods for the detection and spread control of emerging KPC-2 carbapenemases in the hospital setting in Brazil.

Key Words: multidrug resistance , class 1 integrons , PCR , PFGE


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