RESUMO
Burkholderia cepacia, a species found infrequently in cystic fibrosis (CF), was isolated from 85% of patients infected with bacteria of the B. cepacia complex that visited the major Portuguese CF center, in Lisbon, during 2003 to 2005. A detailed molecular analysis revealed that this was mainly due to two B. cepacia clones. These clones were indistinguishable from two strains isolated from intrinsically contaminated nonsterile saline solutions for nasal application, detected during routine market surveillance by the Portuguese Medicines and Health Products Authority.
Assuntos
Infecções por Burkholderia/epidemiologia , Infecções por Burkholderia/microbiologia , Complexo Burkholderia cepacia/isolamento & purificação , Burkholderia cepacia/isolamento & purificação , Fibrose Cística/complicações , Fibrose Cística/epidemiologia , Infecções por Burkholderia/complicações , Humanos , Vigilância da População , Portugal/epidemiologia , Fatores de TempoRESUMO
Between November 2001 and November 2004, 231 Escherichia coli isolates resistant to beta-lactam antibiotics were identified. In 14 isolates, bla(TEM-24) (2 isolates), bla(TEM-52) (5 isolates) and bla(TEM-26) (7 isolates) were identified. In 145 E. coli isolates with the same M13 fingerprinting profile and the same resistance phenotype, the bla(CTX-M-15) gene was found in association with an insertion sequence ISEcp1. The bla(CTX-M-2) gene was identified in one E. coli isolate (290HSM), and in other E. coli isolate (246HSM) the bla(CTX-M-9) gene was contained in a new complex sul1-type class 1 integron (named In60A). This is the first report of three cefotaximases (CTX-M-15, CTX-M-2 and CTX-M-9) in E. coli isolates from a Portuguese hospital.
Assuntos
Proteínas de Escherichia coli/metabolismo , Escherichia coli/enzimologia , Escherichia coli/genética , Integrons/genética , beta-Lactamases/metabolismo , Criança , Pré-Escolar , DNA Bacteriano/genética , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/microbiologia , Proteínas de Escherichia coli/genética , Feminino , Hospitais , Humanos , Masculino , Portugal/epidemiologia , Resistência beta-Lactâmica , beta-Lactamases/genéticaAssuntos
Bacteriemia/microbiologia , Infecções por HIV/microbiologia , HIV-1 , Mycobacterium tuberculosis/crescimento & desenvolvimento , Tuberculose/microbiologia , Bacteriemia/sangue , Bacteriemia/virologia , Infecções por HIV/sangue , Humanos , Portugal , Estudos Retrospectivos , Fatores de Tempo , Tuberculose/sangue , Tuberculose/virologiaRESUMO
Six clinical isolates of Enterobacter cloacae isolated in a Portuguese hospital, between April 1999 and November 2000, demonstrated resistance to almost all broad-spectrum cephalosporins, except to cefepime. These isolates were susceptible to quinolones and to aminoglycosides. Isoelectric focusing demonstrated production of beta-lactamases with pIs > 8.0 and by all six isolates, exhibiting a cephalosporinase phenotype. The results of pulsed field gel electrophoresis revealed that these isolates were genetically unrelated. The amino acid sequence of six AmpC beta-lactamases (Eclo1FF, Eclo6FF, Eclo9FF, Eclo10FF, Eclo11FF and Eclo15FF) shared 97-99% homology with the chromosomal AmpC beta-lactamase from E. cloacae P99 and 86-87% homology with those of two plasmid-mediated AmpC beta-lactamases, MIR-1 and ACT-1. This is the first report of chromosomal AmpC beta-lactamase production by E. cloacae isolates in a Portuguese hospital.
Assuntos
Proteínas de Bactérias , Cromossomos Bacterianos , Enterobacter cloacae/enzimologia , Infecções por Enterobacteriaceae/epidemiologia , Variação Genética , Hospitais Urbanos , beta-Lactamases/metabolismo , Sequência de Aminoácidos , Resistência às Cefalosporinas , Enterobacter cloacae/efeitos dos fármacos , Enterobacter cloacae/genética , Infecções por Enterobacteriaceae/microbiologia , Genótipo , Humanos , Testes de Sensibilidade Microbiana , Dados de Sequência Molecular , Filogenia , Reação em Cadeia da Polimerase , Portugal/epidemiologia , Prevalência , Transformação Bacteriana , beta-Lactamases/genética , beta-Lactamas/farmacologiaRESUMO
This work reports results of a systematic molecular analysis involving 113 Burkholderia cepacia complex isolates obtained from 23 cystic fibrosis (CF) patients under surveillance over a 7-year period at the major Portuguese CF center, the Santa Maria Hospital in Lisbon. The majority of the isolates were serial isolates from persistently infected patients (more than one-half of the population examined). In agreement with previous studies, B. cenocepacia (formerly genomovar III) was the most prevalent species; it was isolated from 52% of the patients infected with B. cepacia complex isolates. Contrasting with previous studies, a very significant percentage of the Portuguese CF subpopulation examined was infected with B. cepacia genomovar I (36%) and B. stabilis (18%). B. multivorans was recovered from two of the infected patients. All four of the species or genomovars were associated with poor clinical outcome, including the cepacia syndrome, and gave rise to chronic and transient infections, with the clinical condition depending on the patient and other still-unidentified factors. The B. cepacia epidemic strain marker region was found exclusively in genomovar III strains, while cblA was detected in genomovars I and III, only. There was no clear relation between the presence of these markers and transmissibility. Altogether, our results indicate that the use of these markers or the genomovar status in identifying patients at higher risk for infection is uncertain.
