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https://www.arca.fiocruz.br/handle/icict/34700
BLOODSTREAM INFECTIONS CAUSED BY MULTIDRUG-RESISTANT GRAM-NEGATIVE BACTERIA: EPIDEMIOLOGICAL, CLINICAL AND MICROBIOLOGICAL FEATURES
Author
Leal, Helena Ferreira
Azevedo, Jailton
Silva, Giulyana Evelyn Oliveira
Amorim, Angelica Maria Lima
Roma, Larissa Rangel Cabral de
Arraes, Ana Carolina Palmeira
Gouveia, Edilane Lins
Reis, Mitermayer Galvão dos
Mendes, Ana Verena
Silva, Marcio de Oliveira
Barberino, Maria Goreth
Martins, Ianick Souto
Reis, Joice Neves
Azevedo, Jailton
Silva, Giulyana Evelyn Oliveira
Amorim, Angelica Maria Lima
Roma, Larissa Rangel Cabral de
Arraes, Ana Carolina Palmeira
Gouveia, Edilane Lins
Reis, Mitermayer Galvão dos
Mendes, Ana Verena
Silva, Marcio de Oliveira
Barberino, Maria Goreth
Martins, Ianick Souto
Reis, Joice Neves
Affilliation
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, Brasil.
Federal University of Bahia. School of Pharmacy. Laboratory of Research on Clinical Microbiology. Salvador, BA, Brazil.
Federal University of Bahia. School of Pharmacy. Laboratory of Research on Clinical Microbiology. Salvador, BA, Brazil.
Federal University of Bahia. School of Pharmacy. Laboratory of Research on Clinical Microbiology. Salvador, BA, Brazil.
São Rafael Hospital. Salvador, BA, Brasil.
Bahia Hospital. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, Brasil.
São Rafael Hospital. Salvador, BA, Brasil / Bahia Foundation for the Development of Sciences. Bahiana School of Medicine and Public Health. Salvador, BA, Brazil.
São Rafael Hospital. Salvador, BA, Brasil.
São Rafael Hospital. Salvador, BA, Brasil.
Fluminense Federal University Downtown. Faculty of Medicine. Niterói, RJ, Brazil.
Federal University of Bahia. School of Pharmacy. Laboratory of Research on Clinical Microbiology. Salvador, BA, Brazil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, Brasil.
Federal University of Bahia. School of Pharmacy. Laboratory of Research on Clinical Microbiology. Salvador, BA, Brazil.
Federal University of Bahia. School of Pharmacy. Laboratory of Research on Clinical Microbiology. Salvador, BA, Brazil.
Federal University of Bahia. School of Pharmacy. Laboratory of Research on Clinical Microbiology. Salvador, BA, Brazil.
São Rafael Hospital. Salvador, BA, Brasil.
Bahia Hospital. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia e Biologia Molecular. Salvador, BA, Brasil.
São Rafael Hospital. Salvador, BA, Brasil / Bahia Foundation for the Development of Sciences. Bahiana School of Medicine and Public Health. Salvador, BA, Brazil.
São Rafael Hospital. Salvador, BA, Brasil.
São Rafael Hospital. Salvador, BA, Brasil.
Fluminense Federal University Downtown. Faculty of Medicine. Niterói, RJ, Brazil.
Federal University of Bahia. School of Pharmacy. Laboratory of Research on Clinical Microbiology. Salvador, BA, Brazil.
Abstract
Background: Bloodstream infections (BSI) are associated with high morbidity and mortality. This scenario worsens with the emergence of drug-resistant pathogens, resulting in infections which are difficult to treat or even untreatable with conventional antimicrobials. The aim of this study is to describe the epidemiological aspects of BSI caused by multiresistant gram-negative bacilli (MDR-GNB). Methods: We conducted a laboratory-based surveillance for gram-negative bacteremia over a 1-year period. The bacterial isolates were identified by MALDI-TOF/MS and the antimicrobial susceptibility testing was performed by VITEK®2. Resistance genes were identified through PCR assays. Results: Of the 143 patients, 28.7% had infections caused by MDR-GNB. The risk factors for MDR bacteremia were male sex, age ≥ 60, previous antimicrobial use, liver disease and bacteremia caused by K. pneumoniae. K. pneumoniae was the most frequently observed causative agent and had the highest resistance level. Regarding the resistance determinants, SHV, TEM, OXA-1-like and CTX-M-gp1 were predominant enzymatic variants, whereas CTX-M-gp9, CTX-M-gp2, KPC, VIM, GES, OXA-48-like, NDM and OXA-23-like were considered emerging enzymes. Conclusions: Here we demonstrate that clinically relevant antibiotic resistance genes are prevalent in this setting. We hope our findings support the development of intervention measures by policy makers and healthcare professionals to face antibiotic resistance.
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