REVIEW ARTICLE


A Global Overview of β-lactam Resistance Genes in Klebsiella pneumoniae



Yone da Silva1, Rafaela Ferrari3, Victor Augustus Marin2, Carlos Adam Conte Junior1, 3, 4, *
1 Faculty of Veterinary Medicine of Universidade Federal Fluminense – UFF, Niterói, Brazil
2 Department of Food Science, School of Nutrition, Federal University of the State of Rio de Janeiro - UNIRIO, Rio de Janeiro, Brazil
3 Institute of Chemistry, Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brazil
4 National Institute of Health Quality Control, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil


© 2019 Junior et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Institute of Chemistry, Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brazil; Tel: +55-21-3938-7825; E-mail: carlosconte@id.uff.br


Abstract

Klebsiella pneumoniae is a gram-negative bacillus of the Enterobacteriaceae family, commonly associated with nosocomial infections. This pathogen is a serious public health problem as some of its strains are resistant to about 95% antimicrobials of the pharmaceutical market. This resistance is promoted by the production of the β-lactamase extended spectrum (ESBL) enzymes, one of the major causes of therapeutic failure. This review evaluated the incidence and distribution of resistance genes from Klebsiella pneumoniae to β-lactams worldwide. Our study was conducted with the subject the organism K. pneumoniae and β-lactamic resistance. The most reported genes were blaSHV-12, blaCTX-M-2 and blaSHV-5; with blaSHV-12 being the most described. The last two were present in all continents, characterizing its cosmopolitan profiles. The greatest genetic diversity was observed in the Asian and Oceania, where 41 different genes were isolated. Additionally, our review points out the coexistence of different classes of β-lactamases in a single bacterial isolate. Finally, knowledge of mechanisms associated with resistance of K. pneumoniae is of great public interest and the verification of resistance genes shows a variation over time and location highlights the importance of evaluating the mechanisms or strategies by which these variations occur.

Keywords: Antibiotic resistance, Enterobacteria, β-lactamase, Global distribution, Antimicrobial Resistance, Klebsiella Preumonia.