RESUMO
BACKGROUND: Serratia marcescens is an important pathogen in hospital infections since organisms resistant to multiple antimicrobials pose a special threat particularly among transplant patients. The aim of this work was to assess the number of strains producing beta-lactamases with extended spectrum (ESBL) among S. marcescens isolated from our patients. MATERIALS AND METHODS: We investigated S. marcescens isolated from 2005 to 2008 for ESBL. The phenotype methods were applied and additionally we chose strains for polymerase chain reactions using primers for the most popular types of ESBL. RESULTS: Over the investigated time, 257 patients were infected with S. marcescens with 188 (73%) displaying an ESBL-positive phenotype. A Molecular analysis showed that most of them produced both CTX-M and TEM beta-lactamases. In the last year, the percentage of ESBL-producing strains decreased, but also in the last year, we isolated S. marcescens resistant to carbapenems from three patients. CONCLUSIONS: The CTX-M type of ESBL predominated among ESBLs produced by strains of S. marcescens. The appearance of strains resistant to carbapenems is alarming.
Assuntos
Antibacterianos/farmacologia , Infecções por Serratia/genética , Serratia marcescens/enzimologia , Transplante/efeitos adversos , beta-Lactamases/genética , Antibacterianos/uso terapêutico , Primers do DNA , Quimioterapia Combinada , Enterobacteriaceae/efeitos dos fármacos , Enterobacteriaceae/genética , Infecções por Enterobacteriaceae/genética , Humanos , Reação em Cadeia da Polimerase , Infecções por Serratia/tratamento farmacológico , Infecções por Serratia/enzimologia , Infecções por Serratia/epidemiologia , Serratia marcescens/genética , Serratia marcescens/isolamento & purificação , beta-Lactamases/classificação , beta-Lactamases/metabolismoRESUMO
OBJECTIVE: Vancomycin-resistant enterococci (VRE) require epidemiological monitoring especially in transplantation wards. The aim of our work was to perform a molecular analysis of vancomycin-resistant Enterococcus faecalis (VREfl) strains among solid organ recipients during various years. MATERIALS AND METHODS: Strains were examined for the presence of different genes determining vancomycin resistance: vanA, vanB, vanD, or vanG by polymerase chain reaction (PCR). Restriction fragment length polymorphism (RFLP)-pulsed field gel electrophoresis (PFGE) was performed on bacterial DNA digested with SmaI enzyme. RESULTS: From 2003 to 2006, we isolated 12 strains of VREfl from 8 patients (2 liver and 6 kidney transplantations). All strains harbored the vanA gene. Among the strains, 5 displayed patterns similar to each other, despite being isolated from different patients, and were susceptible to ampicillin with high resistance to aminoglycosides. CONCLUSIONS: These results suggested that a single strain of VREfl was present for 3 years in closely related hospital wards, but it disappeared in the following years.
Assuntos
Enterococcus faecalis/efeitos dos fármacos , Infecções por Bactérias Gram-Positivas/epidemiologia , Transplante de Órgãos/efeitos adversos , DNA Bacteriano/genética , DNA Bacteriano/isolamento & purificação , Eletroforese em Gel de Campo Pulsado , Enterococcus faecalis/genética , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Humanos , Transplante de Rim/efeitos adversos , Transplante de Fígado/efeitos adversos , Polimorfismo de Fragmento de Restrição , Complicações Pós-Operatórias/microbiologia , Estudos Retrospectivos , Vancomicina/uso terapêutico , Resistência a Vancomicina/genéticaRESUMO
BACKGROUND: The aim of the study was to estimate the carbapenems resistance and occurrence of metallo-beta-lactamase (MBL) production among Pseudomonas aeruginosa isolated from patients during the last 2 years. MATERIALS AND METHODS: We investigated all P aeruginosa strains derived from Transplantation Institute patients, hospitalized from January 2007 to December 2008. E-tests as well as the three-discs method with imipenem, ceftazidime were used for MBL detection. For the chosen strains, a PCR method was applied for detection of genes determining VIM, IMP, and SMP. RESULTS: Among 311 isolated strains from 228 patients only one strain was used for each patient. We showed increased resistance to carbapenems among P aeruginosa in 2008 compared with 2007: from 14% to 22%. About 60% of resistant strains displayed the MBL phenotype. Upon PCR analysis, the VIM-type metallo-beta-lactamase was detected in 70% of them. CONCLUSIONS: Despite similar numbers of P aeruginosa-infected patients in 2007 and 2008, the percentage of MBL-producing strains increased from 7% to 15%. Most MBLs belonged to the VIM type.
Assuntos
Carbapenêmicos/farmacologia , Farmacorresistência Bacteriana , Infecções por Pseudomonas/tratamento farmacológico , Pseudomonas aeruginosa/efeitos dos fármacos , Transplante/efeitos adversos , beta-Lactamases/genética , Carbapenêmicos/uso terapêutico , Primers do DNA , Humanos , Reação em Cadeia da Polimerase , Pseudomonas aeruginosa/enzimologia , Pseudomonas aeruginosa/genética , Pseudomonas aeruginosa/isolamento & purificaçãoRESUMO
BACKGROUND: The aim of the investigations was to compare the vancomycin-resistant Enterococcus faecium (VREfm) strains obtained from our patients. MATERIALS AND METHODS: Strains were compared using restriction fragment length polymorphism-pulsed field gel electrophoresis (RFLP-PFGE) of bacterial DNA. RESULTS: VREfm infected 26 liver recipients, 22 kidney recipients, and 9 other surgery or nephrology patients. Only five strains possessed the vanB determinant. The PFGE analysis revealed two large and several small groups of related strains. CONCLUSIONS: The PFGE analysis enabled the investigation of VRE epidemiology among patients after transplantation. Strains with similar patterns most probably originated from one source and clearly suggested an outbreak.
