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Emergence of extended-spectrum ß-lactamase producing Enterobacter spp. in patients with bacteremia in a tertiary hospital in southern Brazil.
Nogueira, Keite da Silva; Paganini, Maria Cristina; Conte, Andréia; Cogo, Laura Lúcia; Taborda de Messias Reason, Iara; da Silva, Márcio José; Dalla-Costa, Libera Maria.
Afiliação
  • Nogueira Kda S; Clinics Hospital, Federal University of Paraná (UFPR), Curitiba, Brazil; Postgraduate Program in Pharmaceutical Sciences of UFPR, Curitiba, Brazil.
  • Paganini MC; Clinics Hospital, Federal University of Paraná (UFPR), Curitiba, Brazil.
  • Conte A; Medical Course of UFPR, Curitiba, Brazil.
  • Cogo LL; Clinics Hospital, Federal University of Paraná (UFPR), Curitiba, Brazil.
  • Taborda de Messias Reason I; Clinics Hospital, Federal University of Paraná (UFPR), Curitiba, Brazil; Postgraduate Program in Pharmaceutical Sciences of UFPR, Curitiba, Brazil.
  • da Silva MJ; Plant Molecular Biology and Genomics of Campinas University (Unicamp), Campinas, Brazil.
  • Dalla-Costa LM; Clinics Hospital, Federal University of Paraná (UFPR), Curitiba, Brazil; Pelé Pequeno Príncipe Faculty and Research Institute (FPP/IPPPP), Curitiba, Brazil. Electronic address: lmdc@ufpr.br.
Enferm Infecc Microbiol Clin ; 32(2): 87-92, 2014 Feb.
Article em En | MEDLINE | ID: mdl-23587705
BACKGROUND: Extended-spectrum ß-lactamases (ESBLs) are increasingly prevalent in Enterobacter spp., posing a challenge to the treatment of infections caused by this microorganism. The purpose of this retrospective study was to evaluate the prevalence, risk factors, and clinical outcomes of inpatients with bacteremia caused by ESBL and non ESBL-producing Enterobacter spp. in a tertiary hospital over the period 2004-2008. METHODS: The presence of blaCTX-M, blaTEM, blaSHV, and blaPER genes was detected by polymerase chain reaction (PCR) and nucleotide sequence analysis. Genetic similarity between strains was defined by pulsed-field gel electrophoresis (PFGE). RESULTS: Enterobacter spp. was identified in 205 of 4907 of the patients who had positive blood cultures during hospitalization. Of those cases, 41 (20%) were ESBL-producing Enterobacter spp. Nosocomial pneumonia was the main source of bacteremia caused by ESBL-producing Enterobacter spp. The presence of this microorganism was associated with longer hospital stays. The ESBL genes detected were: CTX-M-2 (23), CTX-M-59 (10), CTX-M-15 (1), SHV-12 (5), and PER-2 (2). While Enterobacter aerogenes strains showed mainly a clonal profile, Enterobacter cloacae strains were polyclonal. CONCLUSION: Although no difference in clinical outcomes was observed between patients with infections by ESBL-producing and non-ESBL-producing strains, the detection of ESBL in Enterobacter spp. resulted in the change of antimicrobials in 75% of cases, having important implications in the decision-making regarding adequate antimicrobial therapy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Proteínas de Bactérias / Beta-Lactamases / Bacteriemia / Resistência beta-Lactâmica / Enterobacter / Infecções por Enterobacteriaceae Tipo de estudo: Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Aged80 / Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: America do sul / Brasil Idioma: En Ano de publicação: 2014 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Proteínas de Bactérias / Beta-Lactamases / Bacteriemia / Resistência beta-Lactâmica / Enterobacter / Infecções por Enterobacteriaceae Tipo de estudo: Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Aged80 / Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: America do sul / Brasil Idioma: En Ano de publicação: 2014 Tipo de documento: Article