Resumo

Klebsiella pneumoniae is an important nosocomial pathogen, especially in patients with severe underlying diseases. Strains of K. pneumoniae carbapenemase-producing (KPC) have been isolated in Brazil since 2005. After the first outbreak in 2009, the National Health Surveillance Agency has recommended that all the samples collected in Brazil should be directed to the Central Public Health Laboratories (LACEN) for confirmation of bacterial multidrug-resistant. FUNED, which is the LACEN of the Brazilian state of Minas Gerais, reported the first KCP isolate in the state in 2009. FUNED notified 17 isolates KPC in 2010 and 98 in 2011. The aim of this study was to identify the main genotypes of Klebsiella pneumoniae carbapenemase-producing circulating in the state of Minas Gerais in the year 2011. First, KPC putative isolates sent to FUNED by the Health Regional Superintendencies (HRS) of Minas Gerais were identified using standard biochemical tests, antibiograms by the disk diffusion method and polymerase chain reaction to detect the blaKPC gene. The KPC confirmed isolates were then genotyped using Random Amplification of Polymorphic DNA (RAPD) and Enterobacterial Repetitive Intergenic Consensus (ERIC-PCR). Molecular serotyping with the cps-RFLP method is ongoing. The results of RAPD and ERIC-PCR mostly corroborate with each other. The 98 KPC isolates were clustered into 11 well-defined genotypes. Most genotypes occurred in more than one geographic region surveyed by different HRSs as expected bearing in mind the important flux of people between the major cities in the state. Exceptionally, one genotype occurred only in Uberlândia (three isolates).This region is located at the border of Minas Gerais. This finding support the idea that a broader national KPC epidemiological survey is needed to monitor the spread of this important pathogen in Brazil. Our preliminary results suggest a complex epidemiology of KPC isolated in 2011 in the state of Minas Gerais where genotype incidence varied along time and space.