Avaliação de heterorresistência ao imipenem em enterobactérias produtoras e não-produtoras de kpc
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Date
2013Author
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Graduation
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Imipenem heteroresistance: evaluation of Klebsiella pneumoniae carbapenemase-producing and non-producing K. pneumoniae and E. coli
Subject
Abstract
The misdetection of Klebsiella pneumoniae carbapenemase (KPC) may lead to treatment failure and favour the spread of this resistance mechanism. Heteroresistance is an antimicrobial resistance in a subset of an isolate considered to be susceptible by conventional testing. The aim of this study was to evaluate the presence of heteroresistance to imipenem in KPC-producing and non-producing K. pneumoniae and E. coli. After the determination of the minimum inhibitory concentration (MIC) to imipenem ...
The misdetection of Klebsiella pneumoniae carbapenemase (KPC) may lead to treatment failure and favour the spread of this resistance mechanism. Heteroresistance is an antimicrobial resistance in a subset of an isolate considered to be susceptible by conventional testing. The aim of this study was to evaluate the presence of heteroresistance to imipenem in KPC-producing and non-producing K. pneumoniae and E. coli. After the determination of the minimum inhibitory concentration (MIC) to imipenem by broth microdilution, each isolate with MIC lower than 4 mg L-1 was subcultured in plates containing imipenem ranging from 0.25 mg L-1 to 32 mg L-1. Isolates with growth in imipenem concentrations two fold dilutions above the original MIC were considered heteroresistant. The KPC group consisted of 10 isolates, while the non-KPC group consisted of four isolates and distinct results were observed among them: all KPC-producing isolates presented heteroresistance to imipenem, while for the KPC-non-producing isolates this phenomenon was not observed. Interestingly, we also found heteroresistance in E. coli isolates, which, to best of our knowledge, was not reported as yet. Our results indicated a possible relationship between heteroresistance and KPC production. The clinical implications of appearing of heteroresistant subpopulations remains to be investigated, considering that this phenomenon seems to be frequent in Gram-negative rods, including members, such as E. coli, in which this phenomenon is still rarely investigated. ...
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Universidade Federal do Rio Grande do Sul. Faculdade de Farmácia. Curso de Farmácia.
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