Diseminación de enterobacterias productoras de carbapenemasas tipo KCP en Venezuela

La resistencia a carbapenems en la familia Enterobacteriaceae constituye un problema creciente a nivel mundial, siendo el mecanismo de mayor impacto clinico, epidemiologico y microbiologico, la produccion de serino-carbapenemasas KPC. Investigar la presencia de carbapenemasas tipo KPC en aislados de Enterobacterias resistentes a carbapenems, provenientes de diversos centros de salud a nivel nacional, durante el periodo mayo 2010 - junio 2011. En esta investigacion se analizaron 91 aislados de Enterobacterias: K pneumoniae (48), E. cloacae (30), E. aerogenes (4), E. coli (2), C. koseri (1), C. freundil (6), con resistencia a carbapenems provenientes de 14 centros de salud. La susceptibilidad antimicrobiana se evaluo siguiendo los criterios de la CLSI 2011. La deteccion fenotipica de carbapenemasas se realizo mediante el test de Hodge modificado y evaluando la sinergia con el acido 3-aminofenilboronico 300 µg/disco. Se realizo el Test de Hodge "doble modificado" a los aislados de Enterobacter y Citrobacter. La deteccion genotipica de carbapenemasas se llevo a cabo mediante PCR utilizando iniciadores para el gen blaKPC. Todos los aislados presentaron a los deinhibicion Resistance to carbapenems is the family Enterobacteriaceae is a growing problem around the world, being production of KPC serino-carbapenemase, the mayor impact clinical, epidemiological and microbiological mechanism. To investigate the presence of KPC carbapenemases in isolates of Enterobacterias resistant to carbapenems, from various health centers nationwide, during the period May-2010 June 2011. In this study were analyzed 91 Enterobacterias isolates: K. pneumoniae (48), E. cloacae (30), E. aerogenes (4), E. coli (2), C. koseri (1), C. freundii (6), with resistance to carbapenems from 14 health centers. Antimicrobial susceptibility was evaluated according to the criteria of the CLSI 2011. Phenotypic detection of carbapenemases was performed by Modified Hodge Test and it was evaluated the synergy with the 3-aminophenylboronic 300 µg/disc. Test were done with "double Modified" Hodge to Enterobacter and Citrobacter isolates. Genotypic detection of carbapenemases was performed out by using PCR primers for the gene blaKPC. All isolated showed inhibition zones