Índice de resistência múltipla aos antimicrobianos e detecção de genes associados à produção de carbapenemases em klebsiella pneumoniae isoladas de diferentes afecções em cães e gatos
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2019-06-28
Autores
Paula, Carolina Lechinski de
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Universidade Estadual Paulista (Unesp)
Resumo
A população de cães e gatos tem aumentado em todo o mundo e o contato próximo entre os tutores e seus animais pode favorecer a transmissão de patógenos de animais de estimação para humanos. Klebsiella pneumoniae são bactérias ubíquas, de comportamento oportunista, relacionadas a várias manifestações clínicas em animais de companhia e infecções nosocomiais em humanos. O micro-organismo comumente é resistente aos antimicrobianos, incluindo aos fármacos carbapenêmicos. O aumento de infecções causadas por bactérias resistentes, por exemplo, como K. pneumoniae produtora de carbapenemases é considerado problema emergente de Saúde Pública. O presente estudo investigou o índice de resistência múltipla aos antimicrobianos utilizando 19 antimicrobianos pertencentes a dez grupos de fármacos, bem como a presença de K. pneumoniae produtora de carbapenemase no teste “in vitro” de difusão com discos usando ertapenem, imipenem e meropenem em 65 linhagens de K. pneumoniae isoladas de afecções de cães e gatos. Todos os isolados foram submetidos a PCR para a detecção dos genes blaKPC, blaNDM e blaOXA-48 (associados com a produção de carbapenemases). Nos cães, cistite (n=26/58; 44,8%) e enterite (n=14/58; 24,1%) foram os sinais clínicos mais comuns; enquanto em gatos, a otite (n=3/7; 42,8%) foi o distúrbio mais frequente. Os isolados apresentaram sensibilidade ≥50% no teste de difusão com discos para ertapenem (67,7%), florfenicol (61,5%), levofloxacino (56,9%) e sulfametoxazol / trimetoprim (50,8%). Em contraste, a maior resistência dos isolados foi observada para rifampicina (100%), azitromicina (92,3%), ceftiofur (56,9%), ceftriaxona (53,8%) e enrofloxacina (50,8%), com grande variedade de perfis de resistência. Os resultados de isolados parcialmente sensíveis e resistentes à identificação fenotípica de K. pneumoniae produtora de carbapenemase revelaram: 29,2% (19/65) e 3,1% (2/65) para ertapenem; 60% (39/65) e 18,5% (12/65) para imipenem; e 47,7% (31/65) e 10,8% (7/65) para meropenem, respectivamente. O IRMA (≥0,3) foi observado em 81,5% (53/65) dos isolados. A PCR detectou 4,6% (3/65) isolados carreando blaNDM e 7,7% (5/65) isolados com blaOXA-48. Poucos estudos, em todo o mundo, têm investigado genes associados à produção de carbapenemases em K. pneumoniae isoladas de animais de companhia. A multirresistência de K. pneumoniae em cães e gatos reforça a preocupação mundial em relação a necessidade do uso racional de antimicrobianos no tratamento de doenças bacterianas em animais de companhia. Na literatura consultada, o presente estudo descreve, pela primeira vez, a detecção do gene blaNDM em K. pneumoniae em cães doentes. Os resultados indicam que os cães podem carrear genes de K. pneumoniae multirresistentes aos antimicrobianos e também servir como reservatório de isolados produtores de carbapenemase para os humanos.
The population of dogs and cats has raised globally and close contact of owners and their animals may favor transmission of pathogens from pets-to-humans. Klebsiella pneumoniae are ubiquitous bacteria, opportunistic in nature, related to various clinical disorders in companion animals and nosocomial infections in humans. This pathogen is usually resistant to conventional antimicrobials, including from carbapenemases group. The increase of infections caused by resistant bacteria, e.g., carbapenemase-producing K. pneumoniae, is an emergent public health issue worldwide. The present study investigated phenotypically the multiple antibiotic resistance (MAR) index to 19 antimicrobials belong to 10 groups of drugs, and carbapenemase-producing K. pneumoniae in the in vitro disk diffusion test using ertapenem, imipenem, and meropenem among 65 K. pneumoniae diseased dogs and cats. In addition, all isolates were subjected to PCR to the detection of the genes blaKPC, blaNDM and blaOXA-48 (associated with the production of carbapenemases). In dogs, cystitis (n=26/58; 44.8%) and enteritis (n=14/58; 24.1%) were the most common clinical signs; whereas in cats, otitis (n=3/7; 60%) was the most frequent disorder. The isolates showed sensitivity ≥50% in the disk diffusion test for ertapenem (67.7%), florfenicol (61.5%), levofloxacin (56.9%), and sulfamethoxazole/trimethoprim (50.8%). In contrast, the highest resistance of the isolates was observed for rifampicin (100%), azithromycin (92.3%), ceftiofur (56.9%), ceftriaxone (53.8%), and enrofloxacin (50.8%) with a great variety of resistance profiles. The results of partially sensitive and resistant isolates to phenotypic identification of carbapenemase-producing K. pneumoniae revealed: 29.2% (19/65) and 3.1% (2/65) to ertapenem; 60% (39/65) and 18.5% (12/65%) to imipenem; and 47.7% (31/65) and 10.8% (7/65) to meropenem, respectively. The MAR index (≥0.3) was observed in 81.5% (53/65) strains. PCR detected 4.6% (3/65) of isolates harboring blaNDM and 7.7 (5/65) isolates blaOXA-48. Few comprehensive studies worldwide have investigated the genes associated with carbapenemase-producing K. pneumoniae isolated from companion animals. The multidrug resistance of K. pneumoniae isolated from dogs and cats sampled highlights the global concern regarding the rational use of antimicrobials in the treatments of bacterial diseases in companion animals. To our knowledge, the present study for the first time describes the detection of the gene blaNDM in K. pneumoniae from diseased dogs. Overall, our results indicate that dogs may harbor multidrug-resistant K. pneumoniae genes and may be a reservoir of carbapenemase-producing isolates to humans.
The population of dogs and cats has raised globally and close contact of owners and their animals may favor transmission of pathogens from pets-to-humans. Klebsiella pneumoniae are ubiquitous bacteria, opportunistic in nature, related to various clinical disorders in companion animals and nosocomial infections in humans. This pathogen is usually resistant to conventional antimicrobials, including from carbapenemases group. The increase of infections caused by resistant bacteria, e.g., carbapenemase-producing K. pneumoniae, is an emergent public health issue worldwide. The present study investigated phenotypically the multiple antibiotic resistance (MAR) index to 19 antimicrobials belong to 10 groups of drugs, and carbapenemase-producing K. pneumoniae in the in vitro disk diffusion test using ertapenem, imipenem, and meropenem among 65 K. pneumoniae diseased dogs and cats. In addition, all isolates were subjected to PCR to the detection of the genes blaKPC, blaNDM and blaOXA-48 (associated with the production of carbapenemases). In dogs, cystitis (n=26/58; 44.8%) and enteritis (n=14/58; 24.1%) were the most common clinical signs; whereas in cats, otitis (n=3/7; 60%) was the most frequent disorder. The isolates showed sensitivity ≥50% in the disk diffusion test for ertapenem (67.7%), florfenicol (61.5%), levofloxacin (56.9%), and sulfamethoxazole/trimethoprim (50.8%). In contrast, the highest resistance of the isolates was observed for rifampicin (100%), azithromycin (92.3%), ceftiofur (56.9%), ceftriaxone (53.8%), and enrofloxacin (50.8%) with a great variety of resistance profiles. The results of partially sensitive and resistant isolates to phenotypic identification of carbapenemase-producing K. pneumoniae revealed: 29.2% (19/65) and 3.1% (2/65) to ertapenem; 60% (39/65) and 18.5% (12/65%) to imipenem; and 47.7% (31/65) and 10.8% (7/65) to meropenem, respectively. The MAR index (≥0.3) was observed in 81.5% (53/65) strains. PCR detected 4.6% (3/65) of isolates harboring blaNDM and 7.7 (5/65) isolates blaOXA-48. Few comprehensive studies worldwide have investigated the genes associated with carbapenemase-producing K. pneumoniae isolated from companion animals. The multidrug resistance of K. pneumoniae isolated from dogs and cats sampled highlights the global concern regarding the rational use of antimicrobials in the treatments of bacterial diseases in companion animals. To our knowledge, the present study for the first time describes the detection of the gene blaNDM in K. pneumoniae from diseased dogs. Overall, our results indicate that dogs may harbor multidrug-resistant K. pneumoniae genes and may be a reservoir of carbapenemase-producing isolates to humans.
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Palavras-chave
K. pneumoniae, Multirresistência aos antimicrobianos, Grupo dos carbapenêmicos, Animais de companhia, Multidrug resistance, Carbapenems, Companion animals