Objective

To demonstrate the finding of a Klebsiella pneumoniae carbapenemase-1 positive, isolated from a 1-year-old female patient with liver illness and kidney recurrent infections.

Methods

Bacterial identification and antimicrobial susceptibility testing was performed with Vitek 2 systems. Phenotypic determination of carbapenemases was performed using boronic acid test and Hodge modified test. Molecular confirmation was done using PCR-RT for gene blaKPC.

Results

Antimicrobial susceptibility testing suggested an extended spectrum betalactamase with reduced sensitivity to carbapenems (imipenem 4 μg/mL, meropenem 1 μg/mL). Boronic acid test and Hodge modified test were consistent with carbapenemase production. Molecular confirmation was positive for carbapenemase-1.

Discusion

The emergence and spread of carbapenemase-positive strains constitutes a risk for patients and community. These strains are usually resistant to multiple antimicrobials and the resistance mechanisms easily spread. Hospitals are scenarios that favor the spread of these bacteria. Therapeutic options in these cases are reduced, so it is necessary a conscious use of antibiotics, hospital hygiene and interdisciplinary epidemiological surveillance.

Conclusions

It is confirmed the presence of Klebsiella pneumoniae KPC-1, isolated from a girl with urinary tract infection and liver illness. The guidelines of Centro Nacional de Reference en Bacteriology, phenotypic tests and molecular confirmation made possible the confirmation of this finding.

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