Molecular and genetic characterization of carbapenemase-producing bacteria in Venezuela.

Carbapenem-resistant Gram-negative bacteria isolated in Venezuela have been poorly characterized. The present study characterized a total of 34 isolates obtained from 27 patients; five of these patients were multi-infected. The bacterial species identified were Klebsiella pneumoniae (17), Pseudomonas aeruginosa (9), and Acinetobacter baumannii (8). From these isolates, 85% were identified as carbapenemase-producing bacteria, and the identified carbapenemase genes were blaKPC-2 (10/29 [34.4%]), blaVIM-type (7/29 [24.1%]), blaOXA-23 (7/29 [24.1%]), blaNDM-1 (8/29 [27.5%]), and the coexistence of blaOXA-23/blaNDM-1 (2/29 [6.8%]). Patient 1 was multi-infected by K. pneumoniae ST11 and ST2413 isolates harbouring the blaNDM-1 and blaKPC-2 genes, respectively. The other patients were multi-infected by two or three different bacterial species such as ESBL-producing K. pneumoniae isolates, P. aeruginosa harbouring the blaVIM-type gene, K. pneumoniae ST147 harbouring the blaKPC-2 gene and by A. baumannii harbouring the blaOXA-23 gene. The blaNDM-1 gene in A. baumannii is flanked by an uncommon genetic structure, whereas blaNDM-1 gene in K. pneumoniae revealed a common structure described in different plasmids from Enterobacteriaceae isolates. This study provides new information about the epidemiology of carbapenemase-producing bacteria in clinical setting in Venezuela.

Development and Characterization of Florfenicol-Loaded BSA Nanoparticles as Controlled Release Carrier.

Florfenicol (FLO) is a broad-spectrum fluorinated antibiotic used for the treatment of bacterial diseases such as bovine respiratory disease (BRD) in cattle. FLO is a poorly soluble drug in aqueous solution, and its encapsulation in various nanovehicles has been reported to be less than 30%. In this context, the use of bovine serum albumin (BSA) as a nanocarrier for FLO is an interesting approach. BSA is a biocompatible, biodegradable, nontoxic, and nonimmunogenic natural protein, allowing the vehiculization of hydrophilic and hydrophobic drugs with a well-tolerated administration. The present work focuses on the fabrication and characterization of florfenicol-loaded BSA (FLO-BSA NPs), incorporation efficiency, and in vitro release pattern. FLO-BSA NPs nanoparticles were successfully obtained by a simple, low-cost and in a few steps method. The physicochemical properties of the obtained nanoparticles such as size (~ 120 nm), polydispersity index (0.04), and zeta potential (approximately - 40 mV) suggest a high colloidal stability and suitable characteristics for drug delivery. The drug loading reveals a high incorporation of florfenicol in the nanoparticles, in which 33.6 molecules of FLO are encapsulated per each molecule of BSA. The in vitro release profile exhibits an initial stage characterized by the burst effect and then a prolonged release of FLO from the albumin matrix, which is compatible with the Higuchi model and which follows a Fickian diffusion. The results together suggest a suitable tool for future investigations in drug delivery field in order to use this nanomaterial in food, pharmaceutical, and veterinary industry.

Carbapenemasas KPC en Enterobacteriaceae aisladas en un Hospital de Maracaibo, Venezuela / KPC Carbapenemase-producing Enterobacteriaceae isolated in a Maracaibo’s Hospital, Venezuela

Los antibióticos carbapenemes representan generalmente los últimos recursos para el tratamiento de infecciones asociadas a los servicios de salud producidas por bacterias Gram negativas multiresistentes. Es preocupante que esta situación esté siendo amenazada en todo el mundo por la aparición de cepas con resistencia a estos antibióticos debido a la producción de Carbapenemasas. Observando este panorama, se caracterizaron tanto fenotípica como genotípicamente las cepas de Enterobacteriaceae productoras de Carbapenemasas tipo KPC aisladas en un Hospital de la región Zuliana, durante 2009 a 2013. Fueron detectadas 423 cepas de Enterobacteriaceae resistentes a los carbapenemes debido a la producción de estas enzimas (36,29%). Los pacientes más afectados fueron adultos de sexo masculino procedentes de la Unidad de Terapia Intensiva. El sitio de colonización más frecuente fue el tracto respiratorio, mientras que el estado de portador rectal fue poco frecuente. Las KPC fueron detectadas principalmente en K. pneumoniae, K. oxytoca, E. coli y E. cloacae, siendo multidrogo-resistentes y extensamente drogo-resistentes. La mayoría de los métodos fenotípicos utilizados permitieron confirmar la presencia de Carbapenemasas y la detección del gen blaKPC confirmó que las carbapenemasas que circulan en cepas de Enterobacteriaceae de nuestra región son del tipo KPC.

Carbapenems have generally been considered the pharmacotherapy of last resort for managing infections associated with health services caused by multidrug-resistant gram-negative bacteria. However, it is worrisome that this situation is being threatened worldwide with the appearance of bacterial strains that resist these antibiotics due to the production of novel b-lactamases with direct carbapenem-hydrolyzing activity (carbapenemases). This study was performed to characterize KPC carbapenemase-producing Enterobacteriaceae isolated from a hospital in the Zulia region during 2009-2013 in terms of their geno- and phenotypes. KPC carbapenemase production was detected in 423 strains of carbapenem-resistant Enterobacteriaceae (36.29%). The most affected patients were male adults from the intensive care unit. The most common site of colonization was the respiratory tract, while rectal carrier status was rare. These KPC carbapenemases were detected mainly in K. pneumoniae, K. oxytoca, E.coli and E. cloacae. Most isolates showed multidrug-resistance and an extensively drug-resistant phenotype. The majority of the phenotypic methods were effective for the detection of KPC producers in Enterobacteriaceae isolates and the presence of blaKPC gene confirmed that the Carbapenemase circulating in Enterobacteriaceae strains in this region are the KPC type.