Magister Public Health - MPH / Ototoxic induced hearing loss is a common adverse event related to aminoglycosides used in Multi Drug Resistant -Tuberculosis treatment. Exposure to ototoxic drugs damages the structures of the inner ear. Symptomatic hearing loss presents as tinnitus, decreased hearing, a blocked sensation, difficulty understanding speech, and perception of fluctuating hearing, dizziness and hyperacusis/recruitment. The World Health Organization (1995) indicated that most cases of ototoxic hearing loss globally could be attributed to treatment with aminoglycosides. The aim of the study was to determine the proportion of DR-TB patients initiated on treatment at three decentralized sites during a defined period (1st October to 31st December 2015) who developed ototoxic induced hearing loss and the corresponding risk factors, whilst receiving audiological monitoring with an extended high frequency audiometer (KUDUwave). A retrospective cross-sectional study was conducted. Cumulatively across the three decentralized sites, 69 patient records were reviewed that met the inclusion criteria of the study. The mean age of the patients was 36.1, with a standard deviation (SD) of 10.7 years; more than half (37) were female. Ototoxicity , a threshold shift, placing patients at risk of developing a hearing loss was detected in 56.5% (n=39)of patients and not detected in 30.4%(n=21).The remaining 13,1% (n=9)is missing data. As a result, the regimen was adjusted in 36.2% of patients. . From the 53 patients who were tested for hearing loss post completion of the injectable phase of treatment, 22.6% (n=12) had normal hearing, 17.0 % (n=9) had unilateral hearing loss, and 60.4% (n=32) had bilateral hearing loss. Therefore, a total of 41 patients had a degree of hearing loss: over 30% (n=22)had mild to moderate hearing loss, and only about 15% (n=11)had severe to profound hearing loss. Analysis of risk factors showed that having ototoxicity detected and not adjusting regimen significantly increases the risk of patients developing a hearing loss. The key findings of the study have shown that a significant proportion of DR-TB patients receiving an aminoglycoside based regimen are at risk of developing ototoxic induced hearing loss, despite receiving audiological monitoring with an extended high frequency audiometer that allows for early detection of ototoxicity (threshold shift).

Title from PDF of title page (University of Missouri--Columbia, viewed on Feb 19, 2010). The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file. Thesis advisor: Dr. Christian Lorson and Dr. Michael Garcia. Includes bibliographical references.

Cationic antimicrobial peptides (CAMPs) are produced by plants, animals and bacteria to protect their host against antagonistic microbes. The antitheses of selective antibiotics, these peptides are drawn by electrostatic and hydrophobic interactions to targets as diverse as the bacterial membrane, nucleic acids and serum proteins. This lack of specificity is their greatest strength, as mutations to single genes rarely lead to bacterial resistance. Resistance may be conferred by large scale alterations in cell envelope composition, which generally reduces bacterial fitness in the absence of peptide. Clinical applications of natural CAMPs are limited, as the peptides are toxic to mammalian cells and rapidly inactivated in vivo by serum albumin and proteases. Faced with these challenges we have prepared a number of CAMP analogues, with the goal of creating lead compounds for further development of antibacterial therapeutics. Much of our work has focused on ultrashort lipopeptides and lipopeptoids, which have properties similar to natural CAMPs and extremely abbreviated sequences. The simple structure of these scaffolds allows rapid creation of CAMP analogues in a brief period of time, allowing us to rapidly explore the structural requirements for CAMP activity. The balance of this work focuses on imparting CAMP-like behaviour to known antibiotics, in order to expand their spectrum of susceptible bacteria and combat the development of drug-resistant bacteria. In particular, the aminoglycosides neomycin and tobramycin have been fused to phenolic disinfectants such as triclosan and biclotymol, in order to improve their diffusion across the bacterial envelope and activity against Gram-negative bacteria.

Cationic antimicrobial peptides (CAMPs) are produced by plants, animals and bacteria to protect their host against antagonistic microbes. The antitheses of selective antibiotics, these peptides are drawn by electrostatic and hydrophobic interactions to targets as diverse as the bacterial membrane, nucleic acids and serum proteins. This lack of specificity is their greatest strength, as mutations to single genes rarely lead to bacterial resistance. Resistance may be conferred by large scale alterations in cell envelope composition, which generally reduces bacterial fitness in the absence of peptide. Clinical applications of natural CAMPs are limited, as the peptides are toxic to mammalian cells and rapidly inactivated in vivo by serum albumin and proteases. Faced with these challenges we have prepared a number of CAMP analogues, with the goal of creating lead compounds for further development of antibacterial therapeutics. Much of our work has focused on ultrashort lipopeptides and lipopeptoids, which have properties similar to natural CAMPs and extremely abbreviated sequences. The simple structure of these scaffolds allows rapid creation of CAMP analogues in a brief period of time, allowing us to rapidly explore the structural requirements for CAMP activity. The balance of this work focuses on imparting CAMP-like behaviour to known antibiotics, in order to expand their spectrum of susceptible bacteria and combat the development of drug-resistant bacteria. In particular, the aminoglycosides neomycin and tobramycin have been fused to phenolic disinfectants such as triclosan and biclotymol, in order to improve their diffusion across the bacterial envelope and activity against Gram-negative bacteria.

As características fenotípicas e genotípicas de 203 isolados de Enterococcus spp. proveniente de diferentes amostras clínicas em dois hospitais localizados na cidade de Porto Alegre, Rio Grande do Sul, Brasil, foram estudadas. As espécies foram identificadas através de testes bioquímicos convencionais e pelo uso do sistema automatizado VITEK 2 (BioMérieux). As concentrações inibitórias mínimas (CIM) para aminoglicosídeos foram determinadas pelo método de diluição em ágar. O alto nível de resistência aos aminoglicosídeos (HLAR) e à ampicilina foi avaliado pelo mesmo método e adicionalmente pelo método de disco-difusão. A diversidade genética de amostras de Enterococcus faecalis com HLAR foi determinada através da digestão do DNA cromossômico com a enzima SmaI seguida de eletroforese em campo pulsado (PFGE). O E. faecalis foi a espécie mais prevalente (93,6%) seguido por E. faecium (4,4%). A resistência entre os isolados clínicos foi de 2,5% à ampicilina, 0,5% à vancomicina, 0,5% à teicoplanina, 33% ao cloranfenicol, 2% à nitrofurantoína, 62,1% à eritromicina, 64,5% à tetraciclina, 24,6% à rifampicina, 30% ao ciprofloxacino e 87,2% à quinupristina-dalfopristina. A prevalência de HLAR foi de 10,3%, sendo 23,6% para gentamicina e 37,4% para estreptomicina. A maioria das amostras sensíveis aos aminoglicosídeos pelo método de disco-difusão apresentaram CIM inferior a 125 μg/mL e 500μg/mL para gentamicina e estreptomicina, respectivamente. A prevalência de Enterococcus resistentes à vancomicina (ERV) foi muito baixa neste estudo. Um grupo clonal predominante foi encontrado entre amostras de E. faecalis com HLR-Ge/St. Os isolados incluídos no grupo clonal foram provenientes de ambos os hospitais, indicando uma disseminação intra e inter-hospitalar deste clone. / The phenotypic and genotypic characteristics of 203 Enterococcus spp isolates recovered from different clinical sources of two hospitals in Porto Alegre, Rio Grande do Sul, Brazil, were studied. The species were identified by conventional biochemical tests and the automated system VITEK 2 (BioMérieux). The minimal inhibitory concentrations (MIC) for aminoglycosides were evaluated by agar dilution method. The evaluation of high-level resistance to aminoglycosides (HLAR) and resistance to ampicillin were carried out by the same method as well as by the disc-diffusion method. The genetic diversity of HLAR E. faecalis was assessed by pulsed-field gel electrophoresis of cromossomal DNA after SmaI digestion. The E. faecalis was the most frequent specie (93.6%), followed by E. faecium (4.4%). The percentage of resistance among the clinical isolates was: 2.5% to ampicillin, 0.5% to vancomycin, 0.5% teicoplanin, 33% to chloramphenicol, 2% to nitrofurantoin, 66.1% to erythromycin, 66.5% to tetracycline, 24.6% to rifampicin, 30% to ciprofloxacin and 87.2% to quinupristin-dalfopristin. A total of 10.3% proved to be HLAR, with 23.6% resistant to gentamicin and 37.4% to streptomycin. Most of the aminoglycosides susceptible isolates by the disc-diffusion method presented MIC lower than 125 μg/mL and 500μg/mL for gentamicin e streptomycin, respectively. The prevalence of vancomycin resistance Enterococcus (VRE) was very low in this study. One predominant clonal group was found among E. faecalis exhibiting HLR-Ge/St. The isolates included in the clonal group were recovered from both hospitals, indicating both intrahospital and interhospital spread of this clone.

Introdução: O tratamento dos pacientes com fibrose cística envolve o uso de medicamentos ototóxicos, sendo que os mais frequentemente utilizados são os antibióticos aminoglicosídeos. Devido ao uso frequente deste tipo de medicamento, os pacientes com fibrose cística apresentam risco de desenvolver perda auditiva. Objetivo: o objetivo deste estudo foi avaliar a audição dos pacientes com fibrose cística pela audiometria de altas frequências (AAF) e emissões otoacústicas por produto de distorção (EOAPD). Pacientes e métodos: estudo transversal retrospectivo e prospectivo, incluindo 75 indivíduos, sendo 39 do grupo de estudo e 36 do grupo controle. Foram realizados os exames de AAF (de 250 a 16.000 Hz) e EOAPD. Resultados: o grupo de estudo apresentou limiares na AAF significativamente mais elevados em 250, 1.000, 8.000, 9.000, 10.000, 12.500 e 16.000 Hz. (p=0,004) e maior prevalência de alterações nas EOAPD em 1.000 e 6.000 Hz (p=0,001), com amplitudes significativamente mais baixas em 1.000, 1.400 e 6.000 Hz. Houve associação significativa entre as alterações dos limiares auditivos na AAF com o número de cursos de aminoglicosídeos realizados (p=0,005). Oitenta e três por cento dos pacientes que realizaram mais de 10 cursos de aminoglicosídeos apresentaram perda auditiva na AAF. Conclusão: Um número expressivo de pacientes com fibrose cística que receberam repetidos cursos de aminoglicosídeos apresentou alterações na AAF e EOAPD. realização de 10 ou mais cursos de aminoglicosídeos esteve associada às alterações na AAF. / Introduction: the treatment of patients with cystic fibrosis involves the use of ototoxic drugs, and the most frequently used are the aminoglycoside antibiotics. Due to the frequent use of this drug, cystic fibrosis patients are at risk to develop hearing loss. Objective: the aim of this study was to evaluate the hearing of patients with cystic fibrosis by high frequency audiometry (HFA) and distortion product otoacoustic emissions (DPOAE). Patients and methods: retrospective and prospective crosssectional study including 75 individuals, 39 of the study group and 36 in the control group. HFA (250 – 16,000 Hz) and DPOAE tests were conducted. Results: the study group had thresholds significantly higher in the HFA in 250, 1,000, 8,000, 9,000, 10,000, 12,500 and 16,000 Hz (p=0.004) and higher prevalence of abnormal DPOAE at 1,000 and 6,000 Hz (p=0.001), with significantly lower amplitudes of 1,000, 1,400 and 6,000 Hz. There was a significant association between changes in hearing thresholds in HFA with the number of courses of aminoglycosides performed (p=0.005). Eighty-three percent of patients who completed more than 10 courses of aminoglycosides had hearing loss in HFA. Conclusion: a significant number of patients with cystic fibrosis who received repeated courses of aminoglycosides showed alterations in HFA and DPOAE.

As características fenotípicas e genotípicas de 203 isolados de Enterococcus spp. proveniente de diferentes amostras clínicas em dois hospitais localizados na cidade de Porto Alegre, Rio Grande do Sul, Brasil, foram estudadas. As espécies foram identificadas através de testes bioquímicos convencionais e pelo uso do sistema automatizado VITEK 2 (BioMérieux). As concentrações inibitórias mínimas (CIM) para aminoglicosídeos foram determinadas pelo método de diluição em ágar. O alto nível de resistência aos aminoglicosídeos (HLAR) e à ampicilina foi avaliado pelo mesmo método e adicionalmente pelo método de disco-difusão. A diversidade genética de amostras de Enterococcus faecalis com HLAR foi determinada através da digestão do DNA cromossômico com a enzima SmaI seguida de eletroforese em campo pulsado (PFGE). O E. faecalis foi a espécie mais prevalente (93,6%) seguido por E. faecium (4,4%). A resistência entre os isolados clínicos foi de 2,5% à ampicilina, 0,5% à vancomicina, 0,5% à teicoplanina, 33% ao cloranfenicol, 2% à nitrofurantoína, 62,1% à eritromicina, 64,5% à tetraciclina, 24,6% à rifampicina, 30% ao ciprofloxacino e 87,2% à quinupristina-dalfopristina. A prevalência de HLAR foi de 10,3%, sendo 23,6% para gentamicina e 37,4% para estreptomicina. A maioria das amostras sensíveis aos aminoglicosídeos pelo método de disco-difusão apresentaram CIM inferior a 125 μg/mL e 500μg/mL para gentamicina e estreptomicina, respectivamente. A prevalência de Enterococcus resistentes à vancomicina (ERV) foi muito baixa neste estudo. Um grupo clonal predominante foi encontrado entre amostras de E. faecalis com HLR-Ge/St. Os isolados incluídos no grupo clonal foram provenientes de ambos os hospitais, indicando uma disseminação intra e inter-hospitalar deste clone. / The phenotypic and genotypic characteristics of 203 Enterococcus spp isolates recovered from different clinical sources of two hospitals in Porto Alegre, Rio Grande do Sul, Brazil, were studied. The species were identified by conventional biochemical tests and the automated system VITEK 2 (BioMérieux). The minimal inhibitory concentrations (MIC) for aminoglycosides were evaluated by agar dilution method. The evaluation of high-level resistance to aminoglycosides (HLAR) and resistance to ampicillin were carried out by the same method as well as by the disc-diffusion method. The genetic diversity of HLAR E. faecalis was assessed by pulsed-field gel electrophoresis of cromossomal DNA after SmaI digestion. The E. faecalis was the most frequent specie (93.6%), followed by E. faecium (4.4%). The percentage of resistance among the clinical isolates was: 2.5% to ampicillin, 0.5% to vancomycin, 0.5% teicoplanin, 33% to chloramphenicol, 2% to nitrofurantoin, 66.1% to erythromycin, 66.5% to tetracycline, 24.6% to rifampicin, 30% to ciprofloxacin and 87.2% to quinupristin-dalfopristin. A total of 10.3% proved to be HLAR, with 23.6% resistant to gentamicin and 37.4% to streptomycin. Most of the aminoglycosides susceptible isolates by the disc-diffusion method presented MIC lower than 125 μg/mL and 500μg/mL for gentamicin e streptomycin, respectively. The prevalence of vancomycin resistance Enterococcus (VRE) was very low in this study. One predominant clonal group was found among E. faecalis exhibiting HLR-Ge/St. The isolates included in the clonal group were recovered from both hospitals, indicating both intrahospital and interhospital spread of this clone.

Introdução: O tratamento dos pacientes com fibrose cística envolve o uso de medicamentos ototóxicos, sendo que os mais frequentemente utilizados são os antibióticos aminoglicosídeos. Devido ao uso frequente deste tipo de medicamento, os pacientes com fibrose cística apresentam risco de desenvolver perda auditiva. Objetivo: o objetivo deste estudo foi avaliar a audição dos pacientes com fibrose cística pela audiometria de altas frequências (AAF) e emissões otoacústicas por produto de distorção (EOAPD). Pacientes e métodos: estudo transversal retrospectivo e prospectivo, incluindo 75 indivíduos, sendo 39 do grupo de estudo e 36 do grupo controle. Foram realizados os exames de AAF (de 250 a 16.000 Hz) e EOAPD. Resultados: o grupo de estudo apresentou limiares na AAF significativamente mais elevados em 250, 1.000, 8.000, 9.000, 10.000, 12.500 e 16.000 Hz. (p=0,004) e maior prevalência de alterações nas EOAPD em 1.000 e 6.000 Hz (p=0,001), com amplitudes significativamente mais baixas em 1.000, 1.400 e 6.000 Hz. Houve associação significativa entre as alterações dos limiares auditivos na AAF com o número de cursos de aminoglicosídeos realizados (p=0,005). Oitenta e três por cento dos pacientes que realizaram mais de 10 cursos de aminoglicosídeos apresentaram perda auditiva na AAF. Conclusão: Um número expressivo de pacientes com fibrose cística que receberam repetidos cursos de aminoglicosídeos apresentou alterações na AAF e EOAPD. realização de 10 ou mais cursos de aminoglicosídeos esteve associada às alterações na AAF. / Introduction: the treatment of patients with cystic fibrosis involves the use of ototoxic drugs, and the most frequently used are the aminoglycoside antibiotics. Due to the frequent use of this drug, cystic fibrosis patients are at risk to develop hearing loss. Objective: the aim of this study was to evaluate the hearing of patients with cystic fibrosis by high frequency audiometry (HFA) and distortion product otoacoustic emissions (DPOAE). Patients and methods: retrospective and prospective crosssectional study including 75 individuals, 39 of the study group and 36 in the control group. HFA (250 – 16,000 Hz) and DPOAE tests were conducted. Results: the study group had thresholds significantly higher in the HFA in 250, 1,000, 8,000, 9,000, 10,000, 12,500 and 16,000 Hz (p=0.004) and higher prevalence of abnormal DPOAE at 1,000 and 6,000 Hz (p=0.001), with significantly lower amplitudes of 1,000, 1,400 and 6,000 Hz. There was a significant association between changes in hearing thresholds in HFA with the number of courses of aminoglycosides performed (p=0.005). Eighty-three percent of patients who completed more than 10 courses of aminoglycosides had hearing loss in HFA. Conclusion: a significant number of patients with cystic fibrosis who received repeated courses of aminoglycosides showed alterations in HFA and DPOAE.

As características fenotípicas e genotípicas de 203 isolados de Enterococcus spp. proveniente de diferentes amostras clínicas em dois hospitais localizados na cidade de Porto Alegre, Rio Grande do Sul, Brasil, foram estudadas. As espécies foram identificadas através de testes bioquímicos convencionais e pelo uso do sistema automatizado VITEK 2 (BioMérieux). As concentrações inibitórias mínimas (CIM) para aminoglicosídeos foram determinadas pelo método de diluição em ágar. O alto nível de resistência aos aminoglicosídeos (HLAR) e à ampicilina foi avaliado pelo mesmo método e adicionalmente pelo método de disco-difusão. A diversidade genética de amostras de Enterococcus faecalis com HLAR foi determinada através da digestão do DNA cromossômico com a enzima SmaI seguida de eletroforese em campo pulsado (PFGE). O E. faecalis foi a espécie mais prevalente (93,6%) seguido por E. faecium (4,4%). A resistência entre os isolados clínicos foi de 2,5% à ampicilina, 0,5% à vancomicina, 0,5% à teicoplanina, 33% ao cloranfenicol, 2% à nitrofurantoína, 62,1% à eritromicina, 64,5% à tetraciclina, 24,6% à rifampicina, 30% ao ciprofloxacino e 87,2% à quinupristina-dalfopristina. A prevalência de HLAR foi de 10,3%, sendo 23,6% para gentamicina e 37,4% para estreptomicina. A maioria das amostras sensíveis aos aminoglicosídeos pelo método de disco-difusão apresentaram CIM inferior a 125 μg/mL e 500μg/mL para gentamicina e estreptomicina, respectivamente. A prevalência de Enterococcus resistentes à vancomicina (ERV) foi muito baixa neste estudo. Um grupo clonal predominante foi encontrado entre amostras de E. faecalis com HLR-Ge/St. Os isolados incluídos no grupo clonal foram provenientes de ambos os hospitais, indicando uma disseminação intra e inter-hospitalar deste clone. / The phenotypic and genotypic characteristics of 203 Enterococcus spp isolates recovered from different clinical sources of two hospitals in Porto Alegre, Rio Grande do Sul, Brazil, were studied. The species were identified by conventional biochemical tests and the automated system VITEK 2 (BioMérieux). The minimal inhibitory concentrations (MIC) for aminoglycosides were evaluated by agar dilution method. The evaluation of high-level resistance to aminoglycosides (HLAR) and resistance to ampicillin were carried out by the same method as well as by the disc-diffusion method. The genetic diversity of HLAR E. faecalis was assessed by pulsed-field gel electrophoresis of cromossomal DNA after SmaI digestion. The E. faecalis was the most frequent specie (93.6%), followed by E. faecium (4.4%). The percentage of resistance among the clinical isolates was: 2.5% to ampicillin, 0.5% to vancomycin, 0.5% teicoplanin, 33% to chloramphenicol, 2% to nitrofurantoin, 66.1% to erythromycin, 66.5% to tetracycline, 24.6% to rifampicin, 30% to ciprofloxacin and 87.2% to quinupristin-dalfopristin. A total of 10.3% proved to be HLAR, with 23.6% resistant to gentamicin and 37.4% to streptomycin. Most of the aminoglycosides susceptible isolates by the disc-diffusion method presented MIC lower than 125 μg/mL and 500μg/mL for gentamicin e streptomycin, respectively. The prevalence of vancomycin resistance Enterococcus (VRE) was very low in this study. One predominant clonal group was found among E. faecalis exhibiting HLR-Ge/St. The isolates included in the clonal group were recovered from both hospitals, indicating both intrahospital and interhospital spread of this clone.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-08-26T13:01:30Z No. of bitstreams: 3 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) ElzaDissertação: 1942336 bytes, checksum: a9041b50df03d17a3c0538c97db03452 (MD5) ElzaDissertação: 1942336 bytes, checksum: a9041b50df03d17a3c0538c97db03452 (MD5) / Made available in DSpace on 2016-08-26T13:01:30Z (GMT). No. of bitstreams: 3 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) ElzaDissertação: 1942336 bytes, checksum: a9041b50df03d17a3c0538c97db03452 (MD5) ElzaDissertação: 1942336 bytes, checksum: a9041b50df03d17a3c0538c97db03452 (MD5) Previous issue date: 2016-02-24 / CAPEs / Klebsiella pneumoniae e Enterobacter aerogenes têm se destacado como importantes agentes de infecções relacionadas à assistência à saúde (IRAS), causando principalmente infecções de feridas, dos tratos urinário e respiratório, além de sepse. Essas infecções são causadas por linhagens bacterianas geralmente multirresistentes. Genes que codificam as enzimas modificadoras de aminoglicosídeos (EMAs) e metiltransferases 16S RNAr podem estar presentes em isolados de enterobactérias também produtores de Klebsiella pneumoniae carbapapenemase (KPC). Portanto, o objetivo deste estudo foi investigar genes que codificam resistência aos aminoglicosídeos em 30 isolados de E. aerogenes e em 28 isolados de K. pneumoniae portadores do gene blaKPC resistentes a amicacina, tobramicina e/ou gentamicina, oriundos de colonização e infecção em pacientes de diferentes hospitais em Recife-PE, Brasil. A investigação dos genes armA, rmtB, rmtD, aac(3)Ia, aac(3)IIa, aac(6´)Ib, ant(2´)Ia e aph(3’)-VI foi realizada através de PCR, seguida de sequenciamento de DNA. Nos isolados de K. pneumoniae observou-se uma maior ocorrência dos genes ant(2´)Ia, seguidos de aac(3)IIa, aph(3’)-VI e aac(6´)Ib. O gene mais encontrado em E. aerogenes foi o aph(3’)-VI, seguidos de aac(3)-IIa e ant(2”)-Ia. Esse é o primeiro relato de aph(3’)-VI em E. aerogenes no Brasil. Os genes aac(3)-Ia, armA, rmtB e rmtD não foram encontrados. Esses achados ressaltam para a gravidade da alta ocorrência de isolados de K. pneumoniae e E. aerogenes portadores de genes para EMAs e gene blaKPC principalmente colonizando pacientes, visto que essas bactérias podem atuar na disseminação de mecanismos de resistência dentro da unidade hospitalar e limitar as opções de tratamento. / Klebsiella pneumoniae and Enterobacter aerogenes have been highlighted as important agents of healthcare-associated infections (HAIs), primarily causing wound, urinary and respiratory tracts infections, and sepsis. These infections are often caused by multiresistant bacterial strains. Genes encoding aminoglycoside modifying enzymes (AMEs) and 16S RNAr methyltransferases can also be present in Enterobacteriaceae isolates producing Klebsiella pneumoniae carbapapenemase (KPC). Therefore, the aim of this study was to investigate genes encoding resistance to aminoglycosides in 30 isolates of E. aerogenes and 28 K. pneumoniae isolates carrying the blaKPC gene and resistant to amikacin, tobramycin and / or gentamicin, from colonization and infection in patients from different hospitals in Recife-PE, Brazil. The investigation of the genes armA, rmtB, rmtD, aac(3)Ia, aac(3)IIa, aac(6´)Ib, ant(2´)Ia e aph(3’)-VI was performed by PCR followed DNA sequencing. In K. pneumoniae isolates there was a higher incidence of genes ant(2´)Ia, followed by aac(3)IIa, aph(3’)-VI e aac(6´)Ib. The gene most frequently found in E. aerogenes was aph(3’)-VI, followed by aac(3)-IIa e ant(2”)-Ia . This is the first report of aph (3 ') - VI in E. aerogenes in Brazil. The genes aac(3)-Ia, armA, rmtB e rmtD were not found. These findings points to the seriousness of the high incidence of isolates of K. pneumoniae and E. aerogenes carriers of AMEs and blaKPC gene, mainly colonizing patients, since these bacteria can act in the dissemination of resistance mechanisms within the hospital and to limit treatment options.