Intrahospital spread of carbapenem-resistant Pseudomonas aeruginosa in a University Hospital in Florianópolis, Santa Catarina, Brazil Disseminação Intrahospitalar de Pseudomonas aeruginosa em Hospital Universitário de Florianópolis, Santa Catarina, Brasil

1. University Hospital, Federal University of Santa Catarina, Florianópolis, SC, Brazil. 2. Department of Clinical Analysis, Federal University of Santa Catarina, Florianópolis, SC, Brazil. 3. Department of Microbiology and Parasitology, Federal University of Santa Catarina, Florianópolis, SC, Brazil. 4. School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil. 5. Clinical Hospital, Federal University of Paraná, Curitiba, PR, Brazil. 6. Colleges Pequeno Príncipe, Research Institute Pelé Pequeno Príncipe, Curitiba, PR, Brazil. Address to: Dra. Libera Maria Dalla-Costa. HC/UAD. Rua Padre Camargo 280, 80060-240 Curitiba, PR, Brasil. Phone: 55 41 3360-7823; Fax: 55 41 3360-7975 e-mail: [email protected] Received in 13/04/2010 Accepted in 12/05/2010 ABSTRACT Introduction: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) has been isolated with increasing frequency in Brazilian hospitals. Since June 2003, its detection in a teaching hospital in the city of Florianópolis, Brazil, has increased. This study aimed to investigate the minimal inhibitory concentration (MIC), presence of Metallo-β-lactamase (MβL) and a possible clonal relationship among the isolates. Methods: The study included 29 CRPA and seven isolates with reduced susceptibility. The MIC was determined by agar-dilution. Detection of MβL was performed by Double Disk Sinergism (DDS) and Combined Disk (CD). The MβL gene was verified by PCR and nucleotide sequence analysis. Epidemiological typing was performed by pulsed-field gel electrophoresis. Results: Among the 29 carbapenem-resistant isolates, polymyxin B presented 100% susceptibility and piperacillin/tazobactam 96.7%. Seventeen (62%) strains were verified as clonal (A clone) and among these, six isolates indicated phenotypically positive tests for MβL and harbored the blaSPM-1 gene. The first CRPA isolates were unrelated to clone A, harbored blaIMP-16 and were phenotypically positive only by CD. Conclusions: The spread of a high-level of resistance clone suggests cross transmission as an important dissemination mechanism and has contributed to the increased rate of resistance to carbapenems. This study emphasizes the need for continuous surveillance and improved strategies for infection control in this institution. Key-words: Pseudomonas aeruginosa. Carbapenem resistance. Nosocomial infections.