Anais do Congresso Paranaense de Microbiologia
IV Congress of Microbiology in Paraná

During COVID-19 pandemic, antibiotics should were empirical treatment for possible community and/or hospitalar acquired respiratory infections coexisting with COVID-19, especially in severe cases. As there is still no proven treatment, uncertainty and insecurity have contributed to the widespread prescribing of antibiotics during the pandemic that is likely to increase long-term antimicrobial resistance. However, the extensive use of carbapenems has resulted in the evolution of plasmid-mediated carbapenemases in K. pneumoniae as well as other members of Enterobacteriaceae.One these mecanisms is emergence of Klebsiella pneumoniae carbapenemase (KPC) and New Deli metalobetalactamases (NDM) coproducing carbapenem-resistant K. pneumoniae (KPC-NDM CRKP) has escalated threat of CRKP to healthcare. This study aimed to evaluate the frequency and coproducing KPC-NDM CRKP in clinical materials of patients at the University Hospital of Londrina, during COVID -19 pandemic, betwen april first 2020 until march 31 2021. The samples were previously identified by the automated system Vitek®2 BioMérieux, using ID 9 panels, the antimicrobial susceptibility test was performed using 238 and 239 panels and interpreted according to the criteria of the Clinical Laboratory Standard Institute (CLSI 2021). The presence of the blaKPC and blaNDM genes were evaluated by the PCR reaction. During the study period, 1265 enterobacterales isolates were identified, of which 1100 CRKP with 86.9%, followed by E. cloacae 81 (6.4%), Serratia spp. 35 (2.7%) %, and another 49 (3.8%) . CRKP carrying blaKPC gene was detected in 823 (74.8%) isolates, also 130 (11.8%) isolates were detected blaNDM gene and 108 (9.8%) coproducing with KPC-NDM CRKP. In surveillance swab cultures, for resistant microorganisms, 36.6% CR KP were isolated, followed by the respiratory tract with 25.3% and urinary tract with 24.6%. The results obtained show, during the study period, K. pneumoniae was the Enterobacteriacea that presented the highest incidence of the blaKPC gene. However, during the pandemic COVID-19, the new carbapenemase NDM was introduced in our hospital and in co-production with KPC further limits treatment options for serious infections KPC- NDM CRKP. Accurate and recent epidemiological data on resistance to antimicrobials are crucial information for knowledge and resolutions without controlling their dissemination microorganisms in the hospital environment.