Resistencia a los antibióticos beta-lactámicos Carbapenems mediada por el gen blaKPC en Klebsiella pneumoniae

Aura Dayana del Carmen Falco Restrepo, Carlos Andrés Aranaga Arias

Resumen


 Los carbapenems son antibióticos â-lactamicos de amplio espectro que se utilizan como terapia de primera línea para tratar pacientes con infecciones graves. Actualmente, la resistencia a carbapenems se asocia con la presencia de â-lactamasas capaces de hidrolizar estos antibióticos. La carbapenemasa de clase A más común es KPC, la cual es codificada por el gen blaKPC que generalmente, se encuentra ubicado en plásmidos. La selección y la rápida propagación de aislados de Klebsiella pneumoniae portadores de estas carbapenemasas se ha convertido en un problema de salud pública a nivel mundial. Esta mini-revision describe uno de los mecanismos más frecuentes de resistencia a carbapenems como lo son las enzimas carbapenemasas tipo KPC. Además se describen las variantes del gen blaKPC asi como el elemento genético móvil, el transposon Tn4401, el principal responsable de su diseminación entre géneros y especies bacterianas diferentes. Finalmente se hace una pequeña revisión cronológica de los reportes de la enzima KPC a nivel mundial.


Palabras clave


resistencia; Carbapenems, KPC; Klebsiella pneumoniae.

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Referencias


Albers-Schonbegr, G., Arisone, H., Kaczka, E,. Kahan F,. Kahan, J., Lago, B., Maiese W., Rhodes, R. & Smith J. (1976). Thienamycin: structure determination and biosynthetic data. Abstract 229. 15th Interscience Conference. Antimicrobial Agents and Chemotherapy. Chicago, Ill. UUEE.

Chagas, T.P., Seki, L.M., da Silva, D.M. & Asensi, M.D. (2011). Occurrence of KPC-2-producing Klebsiella pneumoniae strains in hospital wastewater. Journal Hospital Infection, 77 (3), 281. doi: 10.1016/j.jhin.2010.10.008.

Chen, L., Mathema, B., Chavda, K., DeLeo, F., Bonomo, R. & Kreiswirth, B. (2014). Carbapenemase-producing Klebsiella pneumoniae: molecular and genetic decoding. Trends in Microbiology, 22 (12), 686-696.

Chen, L., Mediavilla, J., Endimiani, A., Rosenthal, M., Zhao, Y., Bonomo, R. & Kreiswirth, B. (2011). Multiplex

Real-Time PCR Assay for Detection and Classification of Klebsiella pneumoniae Carbapenemase Gene (blaKPC) Variants. Journal of Clinical Microbiology, 49 (2), 579–585.

Cuzon, G., Naas, T., Truong, H., Villegas, M., Wisell, K., Carmeli, Y., Gales, A., Navon-Venezia S., Quinn, J.

& Nordmann, P. (2010). Worldwide Diversity of Klebsiella pneumoniae That Produces β-Lactamase blaKPC-2 Gene. Emerging Infectious Diseases, 16 (9), 1349-1356.

Da Silva, R., Traebert, J. & Galato, D. (2012). Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae: a review of epidemiological and clinical aspects. Expert Opinion Biological Therapy, 12 (6), 663-671.

Diene, S. & Rolain, J. (2014). Carbapenemase genes and genetic platforms in Gram-negative bacilli: Enterobacteriaceae, Pseudomonas and Acinetobacter species. Clinical Microbiology and Infection, 20 (9), 831-838.

Fresnadillo, M., Garcia, I., Gracia, E. & Garcia, J. (2010). Los carbapenems disponibles: propiedades y diferencias. Enferm Infecc Microbiol Clin, 28 (2), 53-64.

Gales, A.C., Castanheira, M, Jones, R.N. & Sader, H.S. (2012). Antimicrobial resistance among Gram-negative bacilli isolated from Latin America: results from SENTRY Antimicrobial Surveillance Program (Latin America, 2008-2010). Diagn Microbiol Infect Dis, 73 (4), 354-360.

Giakkoupi, P., Papagiannitsis, C.C., Miriagou, V., Pappa, O., Polemis, M. & Tryfinopoulou, K. (2011). An update of the evolving epidemic of blaKPC-2-carrying Klebsiella pneumoniae in Greece (2009-10). Journal of Antimicrobial Chemotherapy, 66 (7), 1510-1513.

Gootz, T., Lescoe, M., Dib-Hajj, F., Dougherty, B., He, W., Della-Latta, P. & Huard, R. (2009). Genetic organization of transposase regions surrounding blaKPC carbapenemase genes on plasmids from Klebsiella strains isolated in a New York City hospital. Antimicrobial Agents and Chemotherapy, 53 (5): 1998–2004.

Gomez SA, Pasteran FG, Faccone D, Tijet N, Rapoport M, Lucero C, Lastovetska O, Albornoz E, Galas M; KPC Group, Melano RG, Corso A, Petroni A. (2011). Clonal dissemination of Klebsiella pneumoniae ST258 harbouring KPC-2 in Argentina. Clinical Microbiology and Infection, 17 (10), 1520-1524.

Hirsch, E. & Tam, V. (2010). Detection and treatment options for Klebsiella pneumoniae carbapenemases

(KPCs): an emerging cause of multidrug-resistant infection. Journal of Antimicrobial Chemotherapy, 65 (6), 1119-1125.

Kattan, J.,Villegas, M. & Quinn, J. (2008) New developments in carbapenems. Clin Microbiol Infect. 14 (12), 1102–1111.

Kitchel, B., Rasheed, J.K., Patel, J.B., Srinivasan, A., Navon-Venezia, S. & Carmeli, Y. (2009). Molecular epidemiology of KPC-producing Klebsiella pneumoniae isolates in the United States: clonal expansion of multilocus sequence type 258. Antimicrob Agents Chemother, 53 (8), 3365-3370.

Labrador, I. & Araque, M. (2014). First Description of KPC-2-Producing Klebsiella oxytoca Isolated from a Pediatric Patient with Nosocomial Pneumonia in Venezuela. Case Reports in Infectious Diseases, 2014,

doi: 10.1155/2014/434987.

Mathers, A., Cox H., Kitchel B., Bonatti H., Brassinga AK., Carroll J., Scheld WM., Hazen KC. & Sifri CD. (2011) Molecular dissection of an outbreak of carbapenem- 121 resistant enterobacteriaceae reveals Intergenus

KPC carbapenemase transmission through a promiscuous plasmid. Mbio, 2 (6): 1-7.

Mojica, M.F., Correa, A., Vargas, D.A., Maya, J.J., Montealegre, M.C. & Rojas, L.J. (2012). Molecular correlates of the spread of KPC-producing Enterobacteriaceae in Colombia. International Journal Antimicrobial Agents, 40 (3), 277-279.

Monteiro, J., Santos, A.F., Asensi, M.D., Peirano, G. & Gales, A.C. (2009). First report of KPC-2-producing

Klebsiella pneumoniae strains in Brazil. Antimicrobial Agents Chemotherapy, 53 (1), 333-334.

Moreno, K. (2013). Carbapenemicos: tipos y mecanismos de resistencia bacterianos. Revista Médica de

Costa Rica y Centro America, 70 (608) 599 – 605

Munoz-Price, L.S., Poirel, L., Bomono, R.A.,Schwaber, M.J., Daikos, G.L. & Cormican, M. (2013). Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases. The Lancet Infectious Diseases, 13 (9), 785-796.

Naas, T., Cuzon, G., Villegas, M.V., Lartigue, M.F., Quinn, J.P. & Nordmann, P. (2008). Genetic structures at the origin of acquisition of the beta-lactamase bla KPC gene. Antimicrob Agents Chemother, 52 (4), 1257-1263.

Nordmann, P., Naas, T. & Poirel, L. (2011). Global spread of Carbapenemase-producing Enterobacteriaceae. Emerging Infectious Diseases, 17 (10), 1791-1798.

Nordmann, P. (2014). Carbapenemase-producing Enterobacteriaceae: overview of a major public health challenge. Médecine et Maladies Infectieuses, 44 (2), 51-56.

Nordmann, P., Cuzon, G. & Nass, T. (2009). The real threat of Klebsiella pneumoniae carbapenemase- producing bacteria. The Lancet Infectious Diseases, 9 (4),228-236.

Nordmann, P., Laurent, D. & Laurent, P. (2012). Carbapenem resistance in Enterobacteriaceae: here is the

storm!. Trends in Molecular Medicine, 18 (5), 263-272.

Papp-Wallace, K., Endimiani, A., Taracila, M. & Bonomo, R. (2011). Carbapenems: Past, Present, and Future. Antimicrobial Agents and Chemotherapy, 55 (11), 4943–4960.

Pasteran, F.G., Otaegui, L., Guerriero, L., Radice, G., Maggiora, R. & Rapoport, M. (2008). Klebsiella pneumoniae Carbapenemase-2, Buenos Aires, Argentina. Emerging Infectious Diseases, 14 (7), 1178-80.

Pereira, P.S., de Araujo, C.F., Seki, L.M., Zahner, V., Carvalho-Assef, A.P. & Asensi MD. ( (2013). Update of the molecular epidemiology of KPC-2-producing Klebsiella pneumoniae in Brazil: spread of clonal complex 11 (ST11, ST437 and ST340). Journal Antimicrobial Chemotherapy, 68 (2), 312-316.

Queenan, A. & Bush, K. (2007). Carbapenemases: theVersatile .- Lactamases. Clinical Microbiology Reviews, 20 (3), 440-458.

Ryan A., Kerri, T., Sharma, S., Phillips, M., Johnson, K. & Morgan, D. (2011). Emergence of Klebsiella pneumoniae Carbapenemase (KPC) - Producing Bacteria. Southern Medical Journal. 104 (1), 40–45.

Sacha, P., Ostas, A., Jaworowska, J., Wieczorek, P., Ojdana, D., Ratajczak, J. & Tryniszewska E. (2009). The KPC type .-lactamases: new enzymes that confer resistance to carbapenems in Gram-negative bacilli. Polish Histochemical et Cytochemical Society, 47 (4), 537-543.

Seki, L.M., Pereira, P.S., de Souza, Mda. P., Conceicao, Mde S., Marques, E.A. & Porto, C.O. (2011). Molecular epidemiology of KPC-2- producing Klebsiella pneumoniae isolates in Brazil: the predominance of sequence type 437. Diagnostic Microbiology and Infectious Disease, 70 (2), 274-277.

Suarez, C., Kattan, J., Guzman, A. & Villegas, M. (2006). Mecanismos de resistencia a carbapenems en P. Aeruginosa, Acinetobacter y Enterobacteriaceae y estrategias para su prevencion y control. Infectio, 10 (2), 85-93.

Temkin, E., Adler, E., Lerner, A. & Carmeli, Y. (2014). Carbapenem-resistant Enterobacteriaceae: biology, epidemiology, and management. Annals of the New York Academy of Sciences 1323, 22-42. doi: 10.1111/ nyas.12537. Recuperado de: http://www.lahey.org/studies/other.asp#table1

Tsai, T., Liou, C., Fung, C., Lin, C. & Siu, K. (2013). Single or in Combination Antimicrobial Resistance Mechanisms of Klebsiella pneumoniae contribute to Varied Susceptibility to Different Carbapenems. Plos One, 8 (11), 1-8.

Villegas, M.V., Kattan, J.N., Quinteros, M.G. & Casellas, J.M. (2008). Prevalence of extended-spectrum betalactamases in South America. Clinical Microbiology Infection, 14 Suppl 1: 154-158.

Villegas, M.V., Lolans, K., Correa, A., Suarez, C.J., Lopez, J.A. & Vallejo, M. (2006). First detection of the plasmid- mediated class A carbapenemase KPC-2 in clinical isolates of Klebsiella pneumoniae from South America. Antimicrobial Agents Chemotherapy, 50 (8), 2880-2882.

Walther-Rasmussen, J. & Hoiby, H. (2007). Class A carbapenemases. Journal of Antimicrobial Chemotherapy 60, 470–482. doi: 10.1093/jac/dkm226.

Wolter, D., Kurpiel, P., Woodford, N., Palepou, M., Goering, R. & Hanson, N. (2009). Phenotypic and Enzymatic Comparative Analysis of the Novel KPC Variant KPC-5 and Its Evolutionary Variants, KPC-2 and KPC- 4. Antimicrobial Agents and Chemotherapy 53 (2), 557–562.

Yigit, H. (2003). Carbapenem-resistant strain of Klebsiella oxytoca harboring carbapenem-hydrolyzing betalactamase KPC-2. Antimicrob. Agents Chemother. 47 (12), 3881–3889

Yigit, H., Queenan, M., Anderson, G., Domenech-Sanchez, A., Biddle, A., Steward, C., Alberti, S., Bush, K.

& Tenover, F. (2001). Novel carbapenem-hydrolyzing beta-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae. Antimicrobial Agents and Chemotherapy 45 (4), 1151–1161.




DOI: https://doi.org/10.22490/21456453.1409

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