Emergence of colistin resistance in the largest university hospital complex of São Paulo, Brazil, over five years

• Published in: The Brazilian journal of infectious diseases Vol. 21; no. 1; pp. 98 - 101
• Main Authors: Rossi, Flávia, Girardello, Raquel, Cury, Ana Paula, Di Gioia, Thais Sabato Romano, Almeida, João Nóbrega de, Duarte, Alberto José da Silva
• Format: Journal Article
• Language: English
• Published: Brazil Elsevier Editora Ltda 01-01-2017; Contexto; Elsevier; Brazilian Society of Infectious Diseases
• Subjects: Acinetobacter - drug effects; Acinetobacter - isolation & purification; Anti-Bacterial Agents - pharmacology; Brazil; Brief Communication; Colistin; Colistin - pharmacology; Colistin-resistant; Drug Resistance, Bacterial - drug effects; Enterobacteriaceae; Enterobacteriaceae - drug effects; Enterobacteriaceae - isolation & purification; Hospitals, University; Humans; INFECTIOUS DISEASES; Management; Microbial Sensitivity Tests; Polymyxin B-resistant; Pseudomonas - drug effects; Pseudomonas - isolation & purification; Retrospective Studies; Supply and demand; Time Factors; University hospitals; Brazil; Brazil; Colistin-resistant; Polymyxin B-resistant; Enterobacteriaceae
• ISSN: 1413-8670; 1678-4391; 1678-4391
• DOI: 10.1016/j.bjid.2016.09.011

Colistin resistance involving Gram-negative bacilli infections is a challenge for health institutions around of the world. Carbapenem-resistance among these isolates makes colistin the last therapeutic option for this treatment. Colistin resistance among Enterobacteriaceae, Acinetobacter spp., and Pseudomonas spp. was evaluated between 2010 and 2014 years, at Hospital das Clínicas, São Paulo, Brazil. Over five years 1346 (4.0%) colistin resistant Gram-negative bacilli were evaluated. Enterobacteriaceae was the most frequent (86.1%) pathogen isolated, followed by Acinetobacter spp. (7.6%), and Pseudomonas spp. (6.3%). By temporal analysis there was a trend for an increase of colistin resistance among Enterobacteriaceae, but not among non-fermentative isolates. Among 1346 colistin resistant isolates, carbapenem susceptibility was observed in 21.5%. Colistin resistance in our hospital has been alarmingly increased among Klebsiella pneumoniae isolates in both KPC positive and negative, thus becoming a therapeutic problem.