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Int J Clin Pract ; 74(4): e13463, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31830351

RESUMO

BACKGROUND: Hospital-acquired infections caused by K pneumoniae are difficult to eradicate since K pneumoniae carries resistance genes for many antimicrobials, including carbapenems. The study aimed to determine the prevalence of hospital-acquired infections caused by multiple drug-resistant K pneumoniae and identify carbapenem and fluoroquinolone resistance by phenotypic and genotypic methods amongst hospitalised patients. METHODS: Two hundred and fifty samples from patients with hospital-acquired infections were included. Identification and susceptibility testing for K pneumoniae isolates was performed by standard methods. The detection of carbapenemase resistance (blaKPC , blaVIM-1 and blaOXA-48 ) and plasmid-mediated quinolone resistance (PMQR; qnrA, qnrB and qnrS) genes was performed using PCR assay. RESULTS: Out of 250 samples, 42 (16.8%) were multiple drug-resistant K pneumoniae, and the frequency of K Pneumoniae isolation was higher in urine samples, in the age group (<10 years), in ICU and in patients with longer hospital stay. Twenty-four (57%) of the isolates were resistant to Meropenem, 13 (31%) were resistant to Imipenem and 35 (83.3%) were resistant to Ciprofloxacin. blaOXA-48 gene was detected in 9 (21.4%) of isolates, and blaVIM-1 gene was detected in 6 (14.3%) of isolates. However, no isolate harboured blaKPC gene. PMQR genes were detected in 100% of ciprofloxacin resistant isolates, and qnrS was the dominant. CONCLUSION: Multidrug-resistant K pneumoniae isolates harbouring blaOXA-48, blaVIM-1 and PMQR genes are emerging in hospitals particularly with long hospital stays.


Assuntos
Antibacterianos/farmacologia , Proteínas de Bactérias/genética , Infecção Hospitalar/microbiologia , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/efeitos dos fármacos , beta-Lactamases/genética , Adolescente , Adulto , Antibacterianos/uso terapêutico , Criança , Ciprofloxacina/farmacologia , Ciprofloxacina/uso terapêutico , Infecção Hospitalar/tratamento farmacológico , Farmacorresistência Bacteriana Múltipla/genética , Feminino , Genótipo , Humanos , Imipenem/farmacologia , Imipenem/uso terapêutico , Infecções por Klebsiella/tratamento farmacológico , Klebsiella pneumoniae/genética , Tempo de Internação , Masculino , Meropeném/farmacologia , Meropeném/uso terapêutico , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Fenótipo , Adulto Jovem
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