Andrade V, Silva J

Idioma: Español
Referencias bibliográficas: 46
Paginas: 524-528
Archivo PDF: 159.13 Kb.

RESUMEN

Objetivo. Caracterizar molecularmente los aislamientos de Klebsiella pneumoniae obtenidos de pacientes pediátricos y del personal de salud en la unidad de cuidados intensivos de un hospital de tercer nivel de atención en la Ciudad de México, Distrito Federal. Material y métodos. Se analizaron 15 aislamientos de Klebsiella pneumoniae colectadas de un brote durante el mes de junio de 1996, ocho de pacientes y siete de personal del Hospital Infantil de México. Los aislamientos fueron caracterizados por electroforesis en gel de campos pulsados (EGCP), amplificación azarosa del polimorfismo de ADN por reacción en cadena de la polimerasa (AAPD-PCR), y serotipificación, isoelectroenfoque de β-lactamasas y secuenciación nucleotídica de productos de la reacción en cadena de la polimerasa. Resultados. El serotipo predominante fue el 61 y correlacionó con los perfiles de AAPD-PCR y EGCP en 11 de los 15 aislamientos. Se identificó una clona predominante productora de SHV-5 con una alta letalidad. Conclusiones. Las técnicas de biología molecular fueron herramientas muy útiles en la caracterización de la clona de K. pneumoniae identificada en pacientes y el personal hospitalario, que sugirieron una posible transmisión cruzada. Estos resultados ilustran que se debe apoyar el fortalecimiento de los programas de control para evitar la diseminación de infecciones nosocomiales en esa unidad en estudio.

REFERENCIAS (EN ESTE ARTÍCULO)

1. González-Vértiz A, Alcántar-Curiel D, Cuauhtli M, Daza C, Gayosso C, Solache G et al. Multiresistant extended-spectrum β-lactamaseproducing Klebsiella pneumoniae causing an outbreak of nosocomial bloodstream infection. Infect Control Hosp Epidemiol 2001; 22:723-725.

2. Vernon MO, Trick WE, Welbel SF, Peterson BJ, Weinstein RA. Adherence with hand hygiene: Does number of sinks matter? Infect Control Hosp Epidemiol 2003; 24:224-225.

3. Jacoby G, Busch K. Aminoacid sequences for TEM, SHV and OXA extended spectrum and inhibitor resistant β-lactamasa. Lahey Clinic. Disponible en: http://www.lahey.org/Studies/?D=http://www.lahey.org/studies/webt.stm&C=404, last modified - 09/03/04.

4. Martínez G, Alpuche C, Anaya C, Alcántara D, Gayosso C, Daza C et al. Outbreak of nosocomial sepsis and pneumonia in a Newborn

5. Intensive Care Unit by multiresistant extended-spectrum β-Lactamaseproducing

6. Klebsiella pneumoniae: High impact on mortality. Infect Control Hosp Epidemiol 2001; 22:725-728.

7. Silva J, Gatica R, Aguilar C, Becerra Z, Garza U, Velázquez M et al. Outbreak of infection with extended-spectrum-β-lactamase-producing Klebsiella pneumoniae in a Mexican hospital. J Clin Microbiol 2001; 39:3193–3196.

8. Miranda G, Castro N, Leaños B, Valenzuela A, Garza-Ramos U, Rojas T et al. Clonal and horizontal dissemination of Klebsiella pneumoniae expressing SHV-5 extended-spectrum β-Lactamase in a Mexican pediatric hospital. J Clin Microbiol 2004; 42:30-35.

9. National Committee for Clinical Laboratory Standards. Methods for dilution antimicrobial susceptibility test for bacteria that grow aerobically. Approved standard M100-S12. Wayne (PA): National Committee for Clinical Laboratory Standards; 2002; 22:42-46.

10. Kieser T. Factors affecting the isolation of CCC DNA from Streptomyces lividans and Escherichia coli. Plasmid 1984; 12:10-36.

11. Miller J. Experiments in molecular genetics. Cold Spring Harbour (NY): Cold Spring Harbour Laboratory; 1992: 82-85.

12. Edwards PR, Fife MA. Capsule types of Klebsiella. 1952; 91:92-104.

13. Eisen D, Russell EG, Tymms M, Roper EJ, Grayson ML, Turnidge J. Random amplified polymorphic DNA and plasmid analysis used in investigation of an outbreak of multiresistant Klebsiella pneumoniae. J Clin Microbiol 1995; 33:713-717.

14. Matthew G, Hedges R, Smith J. Types of β-lactamases determined by plasmid in gram-negative bacteria. J Bacteriol 1979; 138:657-662.

15. Silva J, Aguilar C. ß-Lactamase bioassay: A simplified method to determine extended-spectrum ß-lactamases (ESBL) in enterobacteria. Arch Med Res 1997; 28:285-287.

16. Kaufmann ME. Pulsed-field gel electrophoresis. Methods Mol Med 1998; 15:17-31.

17. Tenover FC, Arbeit RD, Goering RV, Mickelsen PA, Murray BE, Persing DH et al. Interpreting chromosomal DNA restriction patterns produced by pulsed- field gel electrophoresis: Criteria for bacterial strain typing. J Clin Microbiol 1995; 33:2233-2239.

18. Barthelemy M, Peduzzi J, Labia R. Complete amino acid sequence of p453-plasmid-mediated PIT-2 β-lactamase (SHV-1). J Biochem 1988; 251:73-79.

19. Mondino SS, Castro AC, Mondino PJ, Carvalho Mda G, Silva KM, Teixeira LM. Phenotypic and genotypic characterization of clinical and intestinal enterococci isolated from inpatients and outpatient: Two Brazilian hospitals. Microb Drug Resist 2003; 9:167-174.

20. Girou E, Azar J, Wolkenstein P, Cizeau F, Brun-Buisson C, Roujeau JC. Comparison of systematic versus selective screening for methicillinresistant Staphylococcus aureus carriage in a high-risk dermatology ward. Infect Control Hosp Epidemiol 2000; 21:583-587.

21. Martínez JI, Baquero F. Interactions among strategies associated with bacterial infection: Pathogenicity, epidemicity, and antibiotic resistance. Clin Microbiol Rev 2002; 15:647-679.

22. Webber M, Piddock L. The importance of efflux pumps in bacterial antibiotic resistance. J Antimicrob Chemother 2003; 51:9-11.

23. Hernández RI, Gaitán MJ, Gaitán GE. Extrinsic contamination of intravenous infusates administered to hospitalized children in Mexico. J Pediatr Infect Dis 2000; 19: 888-890.

24. Macías AE, Bruckner DA, Hindler JA. Parenteral infusions as culture media from a viewpoint of nosocomial bacteremia. Rev Invest Clin 2000; 52: 39-43.

25. González-Vértiz A, Alcántar-Curiel D, Cuauhtli M, Daza C, Gayosso C, Solache G et al. Multiresistant extended-spectrum β-lactamaseproducing Klebsiella pneumoniae causing an outbreak of nosocomial bloodstream infection. Infect Control Hosp Epidemiol 2001; 22:723-725.

26. Vernon MO, Trick WE, Welbel SF, Peterson BJ, Weinstein RA. Adherence with hand hygiene: Does number of sinks matter? Infect Control Hosp Epidemiol 2003; 24:224-225.

27. Jacoby G, Busch K. Aminoacid sequences for TEM, SHV and OXA extended spectrum and inhibitor resistant β-lactamasa. Lahey Clinic. Disponible en: http://www.lahey.org/Studies/?D=http://www.lahey.org/studies/webt.stm&C=404, last modified-09/03/04.

28. Martínez G, Alpuche C, Anaya C, Alcántara D, Gayosso C, Daza C et al. Outbreak of nosocomial sepsis and pneumonia in a Newborn Intensive Care Unit by multiresistant extended-spectrum β-Lactamaseproducing Klebsiella pneumoniae: High impact on mortality. Infect Control Hosp Epidemiol 2001; 22:725-728.

29. Silva J, Gatica R, Aguilar C, Becerra Z, Garza U, Velázquez M et al. Outbreak of infection with extended-spectrum-β-lactamase-producing Klebsiella pneumoniae in a Mexican hospital. J Clin Microbiol 2001; 39:3193–3196.

30. Miranda G, Castro N, Leaños B, Valenzuela A, Garza-Ramos U, Rojas T et al. Clonal and horizontal dissemination of Klebsiella pneumoniae expressing SHV-5 extended-spectrum β-Lactamase in a Mexican pediatric hospital. J Clin Microbiol 2004; 42:30-35.

31. National Committee for Clinical Laboratory Standards. Methods for dilution antimicrobial susceptibility test for bacteria that grow aerobically. Approved standard M100-S12. Wayne (PA): National Committee for Clinical Laboratory Standards; 2002; 22:42-46.

32. Kieser T. Factors affecting the isolation of CCC DNA from Streptomyces lividans and Escherichia coli. Plasmid 1984; 12:10-36.

33. Miller J. Experiments in molecular genetics. Cold Spring Harbour (NY): Cold Spring Harbour Laboratory; 1992: 82-85.

34. Edwards PR, Fife MA. Capsule types of Klebsiella. 1952; 91:92-104.

35. Eisen D, Russell EG, Tymms M, Roper EJ, Grayson ML, Turnidge J. Random amplified polymorphic DNA and plasmid analysis used in investigation of an outbreak of multiresistant Klebsiella pneumoniae. J Clin Microbiol 1995; 33:713-717.

36. Matthew G, Hedges R, Smith J. Types of β-lactamases determined by plasmid in gram-negative bacteria. J Bacteriol 1979; 138:657-662.

37. Silva J, Aguilar C. ß-Lactamase bioassay: A simplified method to determine extended-spectrum ß-lactamases (ESBL) in enterobacteria. Arch Med Res 1997; 28:285-287.

38. Kaufmann ME. Pulsed-field gel electrophoresis. Methods Mol Med 1998; 15:17-31.

39. Tenover FC, Arbeit RD, Goering RV, Mickelsen PA, Murray BE, Persing DH et al. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: Criteria for bacterial strain typing. J Clin Microbiol 1995; 33:2233-2239.

40. Barthelemy M, Peduzzi J, Labia R. Complete amino acid sequence of p453-plasmid-mediated PIT-2 β-lactamase (SHV-1). J Biochem 1988; 251:73-79.

41. Mondino SS, Castro AC, Mondino PJ, Carvalho Mda G, Silva KM, Teixeira LM. Phenotypic and genotypic characterization of clinical and intestinal enterococci isolated from inpatients and outpatient: Two Brazilian hospitals. Microb Drug Resist 2003; 9:167-174.

42. Girou E, Azar J, Wolkenstein P, Cizeau F, Brun-Buisson C, Roujeau JC. Comparison of systematic versus selective screening for methicillinresistant Staphylococcus aureus carriage in a high-risk dermatology ward. Infect Control Hosp Epidemiol 2000; 21:583-587.

43. Martínez JI, Baquero F. Interactions among strategies associated with bacterial infection: Pathogenicity, epidemicity, and antibiotic resistance. Clin Microbiol Rev 2002; 15:647-679.

44. Webber M, Piddock L. The importance of efflux pumps in bacterial antibiotic resistance. J Antimicrob Chemother 2003; 51:9-11.

45. Hernández RI, Gaitán MJ, Gaitán GE. Extrinsic contamination of intravenous infusates administered to hospitalized children in Mexico. J Pediatr Infect Dis 2000; 19: 888-890.

46. Macías AE, Bruckner DA, Hindler JA. Parenteral infusions as culture media from a viewpoint of nosocomial bacteremia. Rev Invest Clin 2000; 52: 39-43.