PMID- 32670210
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 1664-302X (Print)
IS  - 1664-302X (Electronic)
IS  - 1664-302X (Linking)
VI  - 11
DP  - 2020
TI  - Characterization of KPC-Producing Serratia marcescens in an Intensive Care Unit 
      of a Brazilian Tertiary Hospital.
PG  - 956
LID - 10.3389/fmicb.2020.00956 [doi]
LID - 956
AB  - Serratia marcescens has emerged as an important opportunistic pathogen 
      responsible for nosocomial and severe infections. Here, we determined phenotypic 
      and molecular characteristics of 54 S. marcescens isolates obtained from patient 
      samples from intensive-care-unit (ICU) and neonatal intensive-care-unit (NIUC) of 
      a Brazilian tertiary hospital. All isolates were resistant to beta-lactam group 
      antibiotics, and 92.6% (50/54) were not susceptible to tigecycline. Furthermore, 
      96.3% showed intrinsic resistance to polymyxin E (colistin), a last-resort 
      antibiotic for the treatment of infections caused by MDR (multidrug-resistant) 
      Gram-negative bacteria. In contrast, high susceptibility to other antibiotics 
      such as fluoroquinolones (81.5%), and to aminoglycosides (as gentamicin 81.5%, 
      and amikacin 85.2%) was found. Of all isolates, 24.1% were classified as MDR. The 
      presence of resistance and virulence genes were examined by PCR and sequencing. 
      All isolates carried KPC-carbapenemase (bla (KPC) ) and extended spectrum 
      beta-lactamase bla (TEM) genes, 14.8% carried bla (OXA-) (1), and 16.7% carried 
      bla (CTX-M-) (1) (group) genes, suggesting that bacterial resistance to beta-lactam 
      antibiotics found may be associated with these genes. The genes SdeB/HasF and 
      SdeY/HasF that are associated with efflux pump mediated drug extrusion to 
      fluoroquinolones and tigecycline, respectively, were found in 88.9%. The 
      aac(6')-Ib-cr variant gene that can simultaneously induce resistance to 
      aminoglycoside and fluoroquinolone was present in 24.1% of the isolates. Notably, 
      the virulence genes to (i) pore-forming toxin (ShlA); (ii) phospholipase with 
      hemolytic and cytolytic activities (PhlA); (iii) flagellar transcriptional 
      regulator (FlhD); and (iv) positive regulator of prodigiosin and serratamolide 
      production (PigP) were present in 98.2%. The genetic relationship among the 
      isolates determined by ERIC-PCR demonstrated that the vast majority of isolates 
      were grouped in a single cluster with 86.4% genetic similarity. In addition, many 
      isolates showed 100% genetic similarity to each other, suggesting that the S. 
      marcescens that circulate in this ICU are closely related. Our results suggest 
      that the antimicrobial resistance to many drugs currently used to treat ICU and 
      NIUC patients, associated with the high frequency of resistance and virulence 
      genes is a worrisome phenomenon. Our findings emphasize the importance of active 
      surveillance plans for infection control and to prevent dissemination of these 
      strains.
CI  - Copyright (c) 2020 Ferreira, Rezende, Damas, Oliveira-Silva, Pitondo-Silva, Brito, 
      Leonardecz, Goes, Campanini, Malavazi, da Cunha and Pranchevicius.
FAU - Ferreira, Roumayne L
AU  - Ferreira RL
AD  - Departamento de Genetica e Evolucao, Universidade Federal de Sao Carlos, Sao 
      Carlos, Brazil.
FAU - Rezende, Graziela S
AU  - Rezende GS
AD  - Departamento de Genetica e Evolucao, Universidade Federal de Sao Carlos, Sao 
      Carlos, Brazil.
FAU - Damas, Marcelo Silva Folhas
AU  - Damas MSF
AD  - Departamento de Genetica e Evolucao, Universidade Federal de Sao Carlos, Sao 
      Carlos, Brazil.
FAU - Oliveira-Silva, Mariana
AU  - Oliveira-Silva M
AD  - Programas de Pos-graduacao em Odontologia e Tecnologia Ambiental, Universidade de 
      Ribeirao Preto, Ribeirao Preto, Brazil.
FAU - Pitondo-Silva, Andre
AU  - Pitondo-Silva A
AD  - Programas de Pos-graduacao em Odontologia e Tecnologia Ambiental, Universidade de 
      Ribeirao Preto, Ribeirao Preto, Brazil.
FAU - Brito, Marcia C A
AU  - Brito MCA
AD  - Laboratorio Central de Saude Publica do Tocantins, Palmas, Brazil.
FAU - Leonardecz, Eduardo
AU  - Leonardecz E
AD  - Departamento de Genetica e Evolucao, Universidade Federal de Sao Carlos, Sao 
      Carlos, Brazil.
FAU - de Goes, Fabiana R
AU  - de Goes FR
AD  - Instituto de Ciencias Matematicas e de Computacao, Universidade de Sao Paulo, Sao 
      Carlos, Brazil.
FAU - Campanini, Emeline Boni
AU  - Campanini EB
AD  - Departamento de Genetica e Evolucao, Universidade Federal de Sao Carlos, Sao 
      Carlos, Brazil.
FAU - Malavazi, Iran
AU  - Malavazi I
AD  - Departamento de Genetica e Evolucao, Universidade Federal de Sao Carlos, Sao 
      Carlos, Brazil.
FAU - da Cunha, Anderson F
AU  - da Cunha AF
AD  - Departamento de Genetica e Evolucao, Universidade Federal de Sao Carlos, Sao 
      Carlos, Brazil.
FAU - Pranchevicius, Maria-Cristina da Silva
AU  - Pranchevicius MDS
AD  - Departamento de Genetica e Evolucao, Universidade Federal de Sao Carlos, Sao 
      Carlos, Brazil.
LA  - eng
PT  - Journal Article
DEP - 20200520
PL  - Switzerland
TA  - Front Microbiol
JT  - Frontiers in microbiology
JID - 101548977
PMC - PMC7326048
OTO - NOTNLM
OT  - ERIC-PCR
OT  - KPC
OT  - Serratia marcescens
OT  - intensive care units
OT  - virulence and resistance genes
EDAT- 2020/07/17 06:00
MHDA- 2020/07/17 06:01
PMCR- 2020/05/20
CRDT- 2020/07/17 06:00
PHST- 2019/10/28 00:00 [received]
PHST- 2020/04/21 00:00 [accepted]
PHST- 2020/07/17 06:00 [entrez]
PHST- 2020/07/17 06:00 [pubmed]
PHST- 2020/07/17 06:01 [medline]
PHST- 2020/05/20 00:00 [pmc-release]
AID - 10.3389/fmicb.2020.00956 [doi]
PST - epublish
SO  - Front Microbiol. 2020 May 20;11:956. doi: 10.3389/fmicb.2020.00956. eCollection 
      2020.