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Int J Infect Dis ; 17(9): e714-7, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23528638

RESUMO

OBJECTIVE: The identification of patients colonized or infected with carbapenemase-producing Enterobacteriaceae (CPE), in order to control and prevent the global spread of multidrug-resistant (MDR) pathogens. METHODS: From June 1 to June 15, 2012, eight Citrobacter freundii strains with reduced susceptibility to carbapenems were isolated from rectal swabs of hospitalized patients during active screening following the detection of a Klebsiella pneumoniae carbapenemase (KPC) -positive patient on the ward. All isolates were analyzed phenotypically and molecularly by PCR and sequencing. Genotype clustering was performed by multilocus sequence typing (MLST) analysis. RESULTS: The isolates showed high rates of multidrug resistance profile. A phenotypic assay for carbapenemase production suggested the presence of metallo-ß-lactamase (MBL). The blaVIM-1 gene was detected in all imipenem-resistant C. freundii isolates. MLST showed that the C. freundii isolates shared the same sequence type (ST). Phylogenetic analysis revealed a strict relationship with an ST5C. freundii isolate from a diarrhea patient in China. CONCLUSIONS: Our findings showed that the active surveillance program for CPE was useful, not only for the detection of KPC-producers, but also to identify and control the spread of other MDR pathogens that could expand the spectrum of circulating MDR pathogens.


Assuntos
Citrobacter freundii/genética , Infecção Hospitalar/epidemiologia , Surtos de Doenças , Infecções por Enterobacteriaceae/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/farmacologia , Citrobacter freundii/classificação , Citrobacter freundii/efeitos dos fármacos , Infecção Hospitalar/microbiologia , Infecções por Enterobacteriaceae/microbiologia , Feminino , Hospitais , Humanos , Itália/epidemiologia , Masculino , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Filogenia , beta-Lactamases/genética
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