Resumo

Introduction: Klebsiella pneumoniae carbapenemase (KPC) producing gram-negative isolates had been described in several countries, mostly from nosocomial infections. Nevertheless, the spread of KPC producing multidrug-resistant bacteria to community or acquisition of blaKPC by isolates outside the hospitals is a cause of great concern. Objective: To describe the first report of blaKPC gene in a community isolate of Serratia marcescens worldwide. Materials and methods: The isolate was obtained from a patient who went to diagnosis in a private laboratory located in Recife, Pernambuco, Brazil. Identification of isolate was initially performed by biochemical tests and confirmed using the matrix assisted laser desorption ionization-time of flight mass spectrometry methodology (MALDI-TOF). Susceptibility testing was performed by Etest and the modified Hodge test (MHT) with ertapenem disk was used for phenotypic detection of carbapenemase activity. Specific primers were used under standard PCR conditions to detect the carbapenemase and ESBL encoding genes like blaSPM, blaIMP, blaVIM, blaKPC, blaCTX-M, blaSHV, blaTEM, blaGES, blaOXA-48, blaOXA-23, blaOXA-24 and blaOXA-58 genes, followed by DNA sequencing. Results and discussion: S. marcescens was isolated on September, 2010, recovered from tracheal aspirate of a 63-year-old male with amyotrophic lateral sclerosis who was at home care assistance since his last hospitalization, on July, 2010. S. marcescens isolate was resistant to aztreonam, cefepime, cefotaxime, ceftriaxone, imipenem, meropenem, gentamicin and ciprofloxacin. Additionally, the isolate showed reduced susceptible to cefazidime. S. marcescens showed MHT positive results carried the blaKPC-2 (GenBank accession number JX131687) and blaTEM-1 genes (GenBank accession number JX293719). Conclusions: Although blaKPC-2 dissemination in S. marcescens has been commonly described in nosocomial strains, intensive care unit patients may continue to be colonized by carbapenemase producing isolates for long periods after being discharged from the hospital, allowing to its potential to spread for households and community. Thus, caregivers should be alert for the presence of multi-drug resistant microorganisms spread in the community setting being it necessary measures to prevent infections not only in hospitals but also in the community.