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Prevalence of Klebsiella pneumoniae carbapenemase - and New Delhi metallo-beta-lactamase-positive K. pneumoniae in Sergipe, Brazil, and combination therapy as a potential treatment option
Vivas, Roberto; Dolabella, Silvio Santana; Barbosa, Ana Andréa Teixeira; Jain, Sona.
  • Vivas, Roberto; Universidade Federal de Sergipe. Programa de Pós-Graduação em Biologia Parasitária. São Cristóvão. BR
  • Dolabella, Silvio Santana; Universidade Federal de Sergipe. Programa de Pós-Graduação em Biologia Parasitária. São Cristóvão. BR
  • Barbosa, Ana Andréa Teixeira; Universidade Federal de Sergipe. Programa de Pós-Graduação em Biologia Parasitária. São Cristóvão. BR
  • Jain, Sona; Universidade Federal de Sergipe. Programa de Pós-Graduação em Biologia Parasitária. São Cristóvão. BR
Rev. Soc. Bras. Med. Trop ; 53: e20200064, 2020. tab, graf
Article in English | SES-SP, ColecionaSUS, LILACS | ID: biblio-1136871
ABSTRACT
Abstract

INTRODUCTION:

Carbapenem-resistant Klebsiella pneumoniae infection lacks treatment options and is associated with prolonged hospital stays and high mortality rates. The production of carbapenemases is one of the most important factors responsible for this multi-resistance phenomenon.

METHODS:

In the present study, we analyzed the presence of genes encoding carbapenemases in K. pneumoniae isolates circulating in one of the public hospitals in the city of Aracaju, Sergipe, Brazil. We also determined the best combination of drugs that display in vitro antimicrobial synergy. First, 147 carbapenem-resistant K. pneumoniae isolates were validated for the presence of blaKPC, bla GES, bla NDM, bla SPM, bla IMP, bla VIM, and bla OXA-48 genes using multiplex polymerase chain reaction. Thereafter, using two isolates (97 and 102), the role of double and triple combinational drug therapy as a treatment option was analyzed.

RESULTS:

Seventy-four (50.3%) isolates were positive for bla NDM, eight (5.4%) for bla KPC, and one (1.2%) for both bla NDM and bla KPC. In the synergy tests, double combinations were better than triple combinations. Polymyxin B and amikacin for isolate 97 and polymyxin B coupled with meropenem for isolate 102 showed the best response.

CONCLUSIONS:

Clinicians in normal practice use multiple drugs to treat infections caused by multi-resistant microorganism; however, in most cases, the benefit of the combinations is unknown. In vitro synergistic tests, such as those described herein, are important as they might help select an appropriate multi-drug antibiotic therapy and a correct dosage, ultimately reducing toxicities and the development of antibiotic resistance.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Bacterial Proteins / Beta-Lactamases / Klebsiella Infections / Klebsiella pneumoniae / Anti-Bacterial Agents Type of study: Prevalence study / Risk factors Limits: Humans Country/Region as subject: South America / Brazil Language: English Journal: Rev. Soc. Bras. Med. Trop Year: 2020 Type: Article Institution/Affiliation country: Universidade Federal de Sergipe/BR

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Full text: Available Index: LILACS (Americas) Main subject: Bacterial Proteins / Beta-Lactamases / Klebsiella Infections / Klebsiella pneumoniae / Anti-Bacterial Agents Type of study: Prevalence study / Risk factors Limits: Humans Country/Region as subject: South America / Brazil Language: English Journal: Rev. Soc. Bras. Med. Trop Year: 2020 Type: Article Institution/Affiliation country: Universidade Federal de Sergipe/BR