The use of molecular typing to evaluate the dissemination of antimicrobial resistance among gram-negative rods in Brazilian hospitals

The use of molecular typing to evaluate the dissemination of antimicrobial resistance among gram-negative rods in Brazilian hospitals

Author Tosin, Iraci Autor UNIFESP Google Scholar
Silbert, Suzane Autor UNIFESP Google Scholar
Sader, Helio Silva Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Federal University of Santa Catarina Centre of Biological Sciences
Abstract Antimicrobial resistance has increased rapidly in Brazil and worldwide during the past few years, giving rise to a growing necessity for antimicrobial resistance surveillance programs. These programs have been instituted in order to monitor bacterial resistance in various regions, and to guide empirical antimicrobial therapy. We evaluated the use of molecular typing in multicenter surveillance programs. We also studied the dissemination modes of selected resistance profiles. Antimicrobial susceptibility to various antimicrobial agents was evaluated by the reference broth microdilution method. Bacterial isolates with selected susceptibility patterns were characterized by pulsed field-gel electrophoresis (PFGE). A total of 119 Gram-negative bacteria were molecularly typed, including 22 imipenem-resistant Pseudomonas aeruginosa, 26 ESBL-producing Escherichia coli, 27 cefoxitin-resistant-ESBL-producing Klebsiella pneumoniae, 33 Enterobacter spp., 8 Citrobacter spp., and 3 S. marcescens isolates resistant to ceftazidime. The isolates were from clinically apparent bacteremia of patients hospitalized in medical centers located in 13 cities of 11 Brazilian states. Our molecular typing results revealed a great genetic diversity among isolates of the same species. However, some major PFGE patterns were found in more than one isolate. All repeated PFGE patterns were detected in only 2 isolates, which were isolated within the same institutions or in different medical centers. We conclude that the ability to characterize organisms phenotypically and genotypically is a powerful epidemiologic tool and it provides unique information that is very important for multicenter surveillance programs.
Keywords Molecular typing
pulsed-field gel electrophoresis
antimicrobial resistance
carbapenem-resistant Pseudomonas aeruginosa
clonal dissemination
Sentinela Program
Language English
Date 2003-12-01
Published in Brazilian Journal of Infectious Diseases. Brazilian Society of Infectious Diseases, v. 7, n. 6, p. 360-369, 2003.
ISSN 1413-8670 (Sherpa/Romeo)
Publisher Brazilian Society of Infectious Diseases
Extent 360-369
Access rights Open access Open Access
Type Article
SciELO ID S1413-86702003000600002 (statistics in SciELO)

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