Antimicrobial resistance in Enterobacteriaceae in Brazil: focus on ß-lactams and polymyxins
Braz. j. microbiol; 47 (supl.1), 2016
Publication year: 2016
ABSTRACT During the last 30 years there has been a dissemination of plasmid-mediated β-lactamases in Enterobacteriaceae in Brazil. Extended spectrum β-lactamases (ESBL) are widely disseminated in the hospital setting and are detected in a lower frequency in the community setting. Cefotaximases are the most frequently detected ESBL type and Klebsiella pneumoniae is the predominant species among ESBL producers. Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae became widely disseminated in Brazil during the last decade and KPC production is currently the most frequent resistance mechanism (96.2%) in carbapenem resistant K. pneumoniae. To date KPC-2 is the only variant reported in Brazil. Polymyxin B resistance in KPC-2-producing K. pneumoniae has come to an alarming rate of 27.1% in 2015 in São Paulo, the largest city in Brazil. New Delhi metallo-β-lactamase was detected in Brazil in 2013, has been reported in different Brazilian states but are not widely disseminated. Antimicrobial resistance in Enterobacteriaceae in Brazil is a very serious problem that needs urgent actions which includes both more strict adherence to infection control measures and more judicious use of antimicrobials.
Antiinfecciosos/farmacología, Infecciones por Enterobacteriaceae/epidemiología, Farmacorresistencia Bacteriana, Infecciones por Enterobacteriaceae/microbiología, Enterobacteriaceae/efectos de los fármacos, Antibacterianos/farmacología, Antibacterianos/uso terapéutico, Antiinfecciosos/uso terapéutico, Proteínas Bacterianas/genética, Proteínas Bacterianas/metabolismo, Brasil/epidemiología, Enterobacteriaceae/enzimología, Enterobacteriaceae/genética, Plásmidos/genética, Polimixinas/farmacología, Polimixinas/uso terapéutico, beta-Lactamasas/genética, beta-Lactamasas/metabolismo, beta-Lactamas/farmacología, beta-Lactamas/uso terapéutico