RESUMO
A retrospective epidemiological survey was carried out to determine the prevalence of carbapenemase producers among enterobacterial clinical isolates recovered in the center of maternity and neonatology of Monastir (Tunisia). PCR screening identified 1 OXA-48 and 2 OXA-204 producers, which coexpressed the CTX-M-15 or the CMY-4 ß-lactamases. PCR mapping showed that the bla(OXA-48) gene was carried by a Tn1999.2 transposon, whereas the bla(OXA-204) gene was part of the Tn2016 transposon-like structure. The OXA-48- or OXA-204-producing Klebsiella pneumoniae clinical isolates and the OXA-204-expressing Escherichia coli clinical isolate belonged to the widespread sequence types ST11, ST101, and ST617, respectively. The OXA-204 enzyme, which is a point derivative of the OXA-48 carbapenemase, had hitherto been reported in 2013 from K. pneumoniae isolate. Our study shows for the first time the dissemination of this resistance marker in E. coli strain. The coproduction of OXA-204 with CTX-M-15 and CMY-4 enzymes may potentiate the risk of multiresistance and may enhance the risk of dissemination.
Assuntos
Infecções por Enterobacteriaceae/epidemiologia , Infecções por Enterobacteriaceae/microbiologia , Escherichia coli/enzimologia , Klebsiella pneumoniae/enzimologia , beta-Lactamases/metabolismo , Elementos de DNA Transponíveis , DNA Bacteriano/química , DNA Bacteriano/genética , Estudos Epidemiológicos , Escherichia coli/genética , Escherichia coli/isolamento & purificação , Ordem dos Genes , Humanos , Recém-Nascido , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/isolamento & purificação , Dados de Sequência Molecular , Reação em Cadeia da Polimerase , Estudos Retrospectivos , Análise de Sequência de DNA , Tunísia/epidemiologia , beta-Lactamases/genéticaRESUMO
The intussusception (IIA) is an invagination of the immediate part of the intestine. She is responsible for a syndrome with an occlusive venous compression and swelling that can rapidly progress to intestinal necrosis. Most cases occur in children aged 6 to 18 months and occur more frequently in boys than girls. There are two types of IIA: the IIA idiopathic representing 90-95% of invaginations of the child and the IIA secondary to local injury of the gastrointestinal tract or occurring in a particular context whose frequency are between 5 and 10%. The pathogenesis of the IIA remains uncertain, but the infectious origin is criminalized in most idiopathic invaginations. This component is dominated by viral agents including adenovirus, rotavirus, enterovirus, human herpesvirus 6 and 7, cytomegalovirus and Epstein-Barrvirus. Bacterial agents are rather found and include Yersinia enterocolitica, Staphylococcus aureus, Escherichia coli O157, H7, Salmonella and Campylobacter. In a small proportion parasitic agents may be reported in the IIA, the most frequently found are Entamoeba histolytica, Trichuris trichuira, Ascaris lumbricoides, Ankylostoma and Giardia.
