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Molecular Characterization of Extended-Spectrum β-Lactamase-Producer Klebsiella pneumoniae Isolates Causing Neonatal Sepsis in Peru
Klebsiella pneumoniae (KP) is the most common cause of neonatal sepsis in the low- and middle-income countries. Our objective was to describe the phenotypic and molecular characteristics of extended-spectrum β-lactamase (ESBL)-producer KP in neonatal care centers from Peru. We collected 176 non-duplicate consecutive KP isolates from blood isolates of neonates from eight general public hospitals of Lima, Peru. The overall rate of ESBL production was 73.3% (N = 129). The resistance rates were higher among ESBL-producer isolates when compared with the nonproducers: 85.3% versus 12.8% for gentamicin (P < 0.01), 59.7% versus 8.5% for trimethoprim–sulfamethoxazole (P < 0.01), 45.0% versus 8.5% for ciprofloxacin (P < 0.01), and 36.4% versus 12.8% for amikacin (P < 0.01). A total of 359 β-lactamase-encoding genes were detected among 129 ESBL-producer isolates; 109 isolates (84.5%) carried two or more genes. Among 37 ESBL-producer isolates randomly selected, CTX-M-15 and CTX-M-2 were the most common ESBLs detected. Most of the isolates (92%) belonged to the group KpI. Pulsed-field gel electrophoresis showed that multiple KP clones were circulating among the eight neonatal units included.
Author Notes
Financial support: This study was sponsored by the Directorate General for Development Cooperation of the Belgian Government, Universidad Peruana Cayetano Heredia, and Agencia Española de Cooperación Internacional para el Desarrollo (AECID).
Authors' addresses: Coralith García and Lizeth Astocondor, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mails: coralith.garcia@upch.pe and lizeth1226@hotmail.com. Beatriz Rojo-Bezares and Yolanda Sáenz, Centro de Investigación Biomédica de La Rioja (CIBIR), Logroño, Spain, E-mails: brojo@riojasalud.es and ysaenz@riojasalud.es. Jan Jacobs, Institute of Tropical Medicine Antwerp, Antwerp, Belgium, E-mail: jjacobs@itg.be.