Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista do Instituto de Medicina Tropical de São Paulo |
Texto Completo: | https://www.revistas.usp.br/rimtsp/article/view/191029 |
Resumo: | Pseudomonas aeruginosa is one of the most common bacterium with a broad spectrum of human-associated infections. It is intrinsically resistant to many antimicrobial drugs, making carbapenems crucial in clinical management. The emergence and dissemination of carbapenemases among P. aeruginosa clinical isolates is a serious public health concern as it limits the options for the treatment of bacterial infections. Here, we described the molecular and epidemiological characteristics of 28 carbapenem-resistant P. aeruginosa strains isolated from patients hospitalized in an intensive care unit (ICU). The antimicrobial susceptibility of carbapenem-resistant P. aeruginosa strains was determined by broth microdilution. The presence of resistance genes was evaluated by PCR and DNA sequencing. Additionally, alterations in genes encoding P. aeruginosa outer membrane proteins were analyzed by PCR as well as SDS-PAGE. Clinical characteristics of the patients and the economic impact of hospitalization on the public health system were evaluated. PCR amplification showed that the blaKPC-2 and blaTEM genes were identified in three isolates (11%) and blaSHV gene in two isolates (7%). Outer membrane profiles obtained by SDS–PAGE indicated that the OprD porin was either absent or was produced at very low levels. A PCR assay using oprD-specific primers failed to show the presence of mutations in this gene. P. aeruginosa strains were isolated from 28 patients, among whom 43% (12/28) had sepsis, 31% (9/28) had respiratory failure, and 31% (9/28) had systemic arterial hypertension. A high mortality rate (39%) was observed in these patients, with an average duration of hospitalization of 34.6 days and a median cost of 3.275 dollars per patient. The production of carbapenemase was not the main mechanism of resistance in these strains. All carbapenem-resistant P. aeruginosa were isolated from patients hospitalized in the ICU. Besides the high mortality rate, many patients remained hospitalized for several days, resulting in a high cost of hospitalization for the public health system. Therefore, the evolution of this resistance and its dissemination should be actively monitored among critically ill patients to improve their health conditions. |
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Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care unitsHealthcare-associated infectionsAntimicrobial resistancePublic healthCarbapenemasePseudomonas aeruginosa is one of the most common bacterium with a broad spectrum of human-associated infections. It is intrinsically resistant to many antimicrobial drugs, making carbapenems crucial in clinical management. The emergence and dissemination of carbapenemases among P. aeruginosa clinical isolates is a serious public health concern as it limits the options for the treatment of bacterial infections. Here, we described the molecular and epidemiological characteristics of 28 carbapenem-resistant P. aeruginosa strains isolated from patients hospitalized in an intensive care unit (ICU). The antimicrobial susceptibility of carbapenem-resistant P. aeruginosa strains was determined by broth microdilution. The presence of resistance genes was evaluated by PCR and DNA sequencing. Additionally, alterations in genes encoding P. aeruginosa outer membrane proteins were analyzed by PCR as well as SDS-PAGE. Clinical characteristics of the patients and the economic impact of hospitalization on the public health system were evaluated. PCR amplification showed that the blaKPC-2 and blaTEM genes were identified in three isolates (11%) and blaSHV gene in two isolates (7%). Outer membrane profiles obtained by SDS–PAGE indicated that the OprD porin was either absent or was produced at very low levels. A PCR assay using oprD-specific primers failed to show the presence of mutations in this gene. P. aeruginosa strains were isolated from 28 patients, among whom 43% (12/28) had sepsis, 31% (9/28) had respiratory failure, and 31% (9/28) had systemic arterial hypertension. A high mortality rate (39%) was observed in these patients, with an average duration of hospitalization of 34.6 days and a median cost of 3.275 dollars per patient. The production of carbapenemase was not the main mechanism of resistance in these strains. All carbapenem-resistant P. aeruginosa were isolated from patients hospitalized in the ICU. Besides the high mortality rate, many patients remained hospitalized for several days, resulting in a high cost of hospitalization for the public health system. Therefore, the evolution of this resistance and its dissemination should be actively monitored among critically ill patients to improve their health conditions.Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo2021-09-29info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rimtsp/article/view/19102910.1590/S1678-9946202163071Revista do Instituto de Medicina Tropical de São Paulo; Vol. 63 (2021); e71Revista do Instituto de Medicina Tropical de São Paulo; Vol. 63 (2021); e71Revista do Instituto de Medicina Tropical de São Paulo; v. 63 (2021); e711678-99460036-4665reponame:Revista do Instituto de Medicina Tropical de São Pauloinstname:Instituto de Medicina Tropical (IMT)instacron:IMTenghttps://www.revistas.usp.br/rimtsp/article/view/191029/176114Copyright (c) 2021 Gleyce Hellen de Almeida de Souza, Luana Rossato, Gabriel Teixeira Brito, Graciela Mendonça dos Santos Bet, Simone Simionattohttps://creativecommons.org/licenses/by-nc/4.0info:eu-repo/semantics/openAccessSouza, Gleyce Hellen de Almeida de Rossato, Luana Brito, Gabriel Teixeira Bet, Graciela Mendonça dos Santos Simionatto, Simone 2022-05-16T13:44:35Zoai:revistas.usp.br:article/191029Revistahttp://www.revistas.usp.br/rimtsp/indexPUBhttps://www.revistas.usp.br/rimtsp/oai||revimtsp@usp.br1678-99460036-4665opendoar:2022-12-13T16:52:59.907587Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)true |
dc.title.none.fl_str_mv |
Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units |
title |
Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units |
spellingShingle |
Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units Souza, Gleyce Hellen de Almeida de Healthcare-associated infections Antimicrobial resistance Public health Carbapenemase |
title_short |
Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units |
title_full |
Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units |
title_fullStr |
Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units |
title_full_unstemmed |
Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units |
title_sort |
Carbapenem-resistant Pseudomonas aeruginosa strains: a worrying health problem in intensive care units |
author |
Souza, Gleyce Hellen de Almeida de |
author_facet |
Souza, Gleyce Hellen de Almeida de Rossato, Luana Brito, Gabriel Teixeira Bet, Graciela Mendonça dos Santos Simionatto, Simone |
author_role |
author |
author2 |
Rossato, Luana Brito, Gabriel Teixeira Bet, Graciela Mendonça dos Santos Simionatto, Simone |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Souza, Gleyce Hellen de Almeida de Rossato, Luana Brito, Gabriel Teixeira Bet, Graciela Mendonça dos Santos Simionatto, Simone |
dc.subject.por.fl_str_mv |
Healthcare-associated infections Antimicrobial resistance Public health Carbapenemase |
topic |
Healthcare-associated infections Antimicrobial resistance Public health Carbapenemase |
description |
Pseudomonas aeruginosa is one of the most common bacterium with a broad spectrum of human-associated infections. It is intrinsically resistant to many antimicrobial drugs, making carbapenems crucial in clinical management. The emergence and dissemination of carbapenemases among P. aeruginosa clinical isolates is a serious public health concern as it limits the options for the treatment of bacterial infections. Here, we described the molecular and epidemiological characteristics of 28 carbapenem-resistant P. aeruginosa strains isolated from patients hospitalized in an intensive care unit (ICU). The antimicrobial susceptibility of carbapenem-resistant P. aeruginosa strains was determined by broth microdilution. The presence of resistance genes was evaluated by PCR and DNA sequencing. Additionally, alterations in genes encoding P. aeruginosa outer membrane proteins were analyzed by PCR as well as SDS-PAGE. Clinical characteristics of the patients and the economic impact of hospitalization on the public health system were evaluated. PCR amplification showed that the blaKPC-2 and blaTEM genes were identified in three isolates (11%) and blaSHV gene in two isolates (7%). Outer membrane profiles obtained by SDS–PAGE indicated that the OprD porin was either absent or was produced at very low levels. A PCR assay using oprD-specific primers failed to show the presence of mutations in this gene. P. aeruginosa strains were isolated from 28 patients, among whom 43% (12/28) had sepsis, 31% (9/28) had respiratory failure, and 31% (9/28) had systemic arterial hypertension. A high mortality rate (39%) was observed in these patients, with an average duration of hospitalization of 34.6 days and a median cost of 3.275 dollars per patient. The production of carbapenemase was not the main mechanism of resistance in these strains. All carbapenem-resistant P. aeruginosa were isolated from patients hospitalized in the ICU. Besides the high mortality rate, many patients remained hospitalized for several days, resulting in a high cost of hospitalization for the public health system. Therefore, the evolution of this resistance and its dissemination should be actively monitored among critically ill patients to improve their health conditions. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-09-29 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/191029 10.1590/S1678-9946202163071 |
url |
https://www.revistas.usp.br/rimtsp/article/view/191029 |
identifier_str_mv |
10.1590/S1678-9946202163071 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/191029/176114 |
dc.rights.driver.fl_str_mv |
https://creativecommons.org/licenses/by-nc/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
https://creativecommons.org/licenses/by-nc/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
dc.source.none.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo; Vol. 63 (2021); e71 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 63 (2021); e71 Revista do Instituto de Medicina Tropical de São Paulo; v. 63 (2021); e71 1678-9946 0036-4665 reponame:Revista do Instituto de Medicina Tropical de São Paulo instname:Instituto de Medicina Tropical (IMT) instacron:IMT |
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Instituto de Medicina Tropical (IMT) |
instacron_str |
IMT |
institution |
IMT |
reponame_str |
Revista do Instituto de Medicina Tropical de São Paulo |
collection |
Revista do Instituto de Medicina Tropical de São Paulo |
repository.name.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT) |
repository.mail.fl_str_mv |
||revimtsp@usp.br |
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1798951653256200192 |