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Phenotypic profile and molecular mechanism of resistance in carbapenemase-producing Enterobacterales and Pseudomonas aeruginosa isolates from Brazilian hospitals

2025-11Artigo científico Acesso aberto
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dc.contributor.authorKurtz, Pedro
dc.contributor.authorDel Peloso, Pedro F.
dc.contributor.authorPribul, Bruno Rocha
dc.contributor.authorAlbuquerque, Arthur M.
dc.contributor.authorAntunes, Bianca B.P.
dc.contributor.authorRamos, Grazielle Vianna
dc.contributor.authorBozza, Fernando A.
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - pólo NMS
dc.contributor.pblFrontiers Research Foundation
dc.date.accessioned2026-01-14T15:52:14Z
dc.date.available2026-01-14T15:52:14Z
dc.date.issued2025-11
dc.descriptionPublisher Copyright: Copyright © 2025 Kurtz, Del Peloso, Pribul, Albuquerque, Antunes, Ramos and Bozza.
dc.description.abstractBackground/Objectives: Carbapenemase-producing Enterobacterales and P. aeruginosa are critical threats to global public health, especially in high-burden regions such as Brazil. Imipenem-relebactam (IMR), a combination of a carbapenem with a β-lactamase inhibitor, is a promising treatment option against resistant Gram-negative bacteria. This study aimed to characterize phenotypic resistance and molecular mechanisms in clinical isolates from Brazilian hospitals and assess IMR activity. Methods: A prospective multicenter study was conducted across 12 hospitals in Rio de Janeiro. A total of 150 Enterobacterales and 100 P. aeruginosa isolates resistant to carbapenems were collected. Isolates were identified by MALDI-TOF and screened for carbapenemase genes (KPC, NDM, VIM, IMP, OXA-48) using PCR. Susceptibility to IMR was determined by broth microdilution following EUCAST guidelines. Next-generation sequencing (NGS) was performed on a subset of multidrug-resistant isolates. Results: IMR resistance was identified in 34.5% of K. pneumoniae and 74% of P. aeruginosa isolates. Among Enterobacterales, 21.1% of KPC-producers and 88.9% of OXA-48-producers were resistant to IMR. The bla_KPC gene was predominant, but NDM was increasingly detected. In P. aeruginosa, resistance was largely unrelated to carbapenemase production, implicating porin loss and efflux pumps. NGS revealed extensive co-resistance and multiple virulence genes in K. pneumoniae isolates. Conclusion: This study highlights the emergence of significant resistance to imipenem-relebactam in Brazil, driven by both enzymatic and non-enzymatic mechanisms. Ongoing molecular surveillance and tailored treatment strategies are essential to address the evolving threat of multidrug-resistant Gram-negative infections in endemic regions.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent280952
dc.identifier.doi10.3389/fmicb.2025.1689777
dc.identifier.issn1664-302X
dc.identifier.otherPURE: 147373702
dc.identifier.otherPURE UUID: 634b0826-8a24-4e9a-a145-7befcd3487ef
dc.identifier.otherScopus: 105023680635
dc.identifier.urihttp://hdl.handle.net/10362/199003
dc.identifier.urlhttps://www.scopus.com/pages/publications/105023680635
dc.language.isoeng
dc.peerreviewedyes
dc.subjectantimicrobial therapy
dc.subjectcarbapenemase
dc.subjectgram-negative
dc.subjectimipenem-relebactam
dc.subjectmulti-drug resistant
dc.subjectMicrobiology
dc.subjectMicrobiology (medical)
dc.subjectSDG 3 - Good Health and Well-being
dc.titlePhenotypic profile and molecular mechanism of resistance in carbapenemase-producing Enterobacterales and Pseudomonas aeruginosa isolates from Brazilian hospitalsen
dc.title.subtitleimplications for the introduction of imipenem-relebactamen
dc.typejournal article
degois.publication.titleFrontiers in Microbiology
degois.publication.volume16
dspace.entity.typePublication
rcaap.rightsopenAccess

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