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Phenotypes of beta-lactamases in Klebsiella pneumoniae from emergency hospital of Porto Alegre

INTRODUCTION: Worldwide, the incidence of nosocomial infections raises the studies of bacterial resistance. Klebsiella pneumoniae is a Gram-negative bacteria most prevalent in the nosocomial environment, capable of expressing a variety of resistance enzymes, justifying their continued monitoring. OBJECTIVE: We sought to determine the frequency of beta-lactamases ESBL, AmpC plasmid, MBL and KPC in K. pneumoniae strains from emergency hospital in Porto Alegre (RS). MATERIAL AND METHOD: Fifty-eight bacterial isolates K. pneumoniae with reduced susceptibility to third generation cephalosporins and/or cefoxitin were included in this study. Phenotypic detection of beta-lactamases was carried out by using specific tests for ESBL, AmpC plasmid, KPC and MBL. RESULTS: Were detected a high frequency of ESBL (48.3%), followed by the AmpC plasmid/ESBL (15.5%), and two carbapenemase strains. DISCUSSION: The high rates of ESBL and ESBL/AmpC leads to the therapeutic use of carbapenens. Consequently, the massive use of carbapenens creates selective pressure favoring the more resistant strains, such as carbapenemase producing (KPC and/or MBL). The carbapenemase is very relevant due to the inherent therapeutic limitation, as well as their potential to spread. The resistance to all beta-lactam drugs used in the screening by disk diffusion can be a "flag" laboratory for presence of relevant mechanisms of resistance. CONCLUSION: Research of resistance phenotypes in Klebsiella is easy and feasible tool in microbiology laboratories, and is fundamental to understanding the local epidemiology of beta-lactamases, allowing the appropriateness of antimicrobial therapy more convenient.

Klebsiella pneumoniae; Bacterial resistance; ESBL; KPC; AmpC plasmidic; MBL


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