Pons, Maria J.Vubil, DelfinoGuiral Vilalta, ElisabetJaintilal, DinisFraile, OscarSoto González, Sara M.Sigaúque, BetuelNhampossa, TaciltaAide, Pedro Carlos PaulinoAlonso, PedroVila Estapé, JordiMandomando, InácioRuiz, Joaquim2016-07-182016-07-182015-01-072213-7165https://hdl.handle.net/2445/100567The aim of this study was to determine the prevalence of extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae isolated from urinary tract and bloodstream infections in a rural hospital in Manhiça, Mozambique. ESBLs were investigated among ceftriaxone-non-susceptible K. pneumoniae clinical isolates recovered between 2004 and 2009. Characterisation of blaCTX-M, blaSHV, blaOXA and blaTEM genes was performed by PCR and sequencing. Epidemiological relationships were established by phylogenetic analysis, repetitive extragenic palindromic PCR (REP-PCR), pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST), whilst plasmid transferability was evaluated by conjugation. In addition, the presence of class 1 and 2 integrons was studied. A total of 19 K. pneumoniae were analysed. The blaCTX-M-15 gene was found in all strains. Other ESBL genes were found concomitantly, including blaSHV-5, blaSHV-2, blaSHV-2A, blaSHV-12 and blaSHV-38. In addition, other β-lactamases such as blaTEM-1 and blaOXA-30 were also detected. REP-PCR identified 15 different epidemiological profiles. MLST analysis also showed great variability of sequence types. The blaCTX-M-15 gene showed a high transfer capacity. The presence of class 1 integrons was high. High levels of multidrug resistance were also found. In conclusion, these data show the dominance of the CTX-M-type ESBL, particularly CTX-M-15, supporting its worldwide dissemination, including in areas with limited access to third-generation cephalosporins. This finding is a matter of concern for clinical management as third-generation cephalosporins are an alternative for treating severe cases of multidrug-resistant infections in this community.33 p.application/pdfengcc by-nc-nd (c) Elsevier, 2015http://creativecommons.org/licenses/by-nc-nd/3.0/es/Klebsiella pneumoniaeInfeccions del tracte urinariMoçambicKlebsiella pneumoniaeUrinary tract infectionsMozambiqueinfo:eu-repo/semantics/article2016-07-01info:eu-repo/semantics/openAccess