Epidemiologia molecular de bastonetes Gram negativos isolados em uma Unidade de Terapia Intensiva de um hospital escola de Goiânia-GO
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2017-03-10
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Universidade Federal de Goiás
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Gram-negative bacilli (BGN) comprise species that are sources of community-acquired infections and infections associated with health care. They are easily spread among humans and have the ability to acquire and share genetic material by horizontal gene transfer. The objective of the study was to determine the prevalence of BGN isolated from the environment and patients of an ICU of a university hospital in the city of Goiânia-GO, to determine the susceptibility profile of the isolates, and their genetic similarity. The collections were performed in patients and environments of the Medical ICU of a university hospital in the city of Goiânia-GO, between December 2012 and June 2014. After collection, the swabs were packed in heart brain infusion broth. Isolation was performed on MacConkey agar and species identification was performed by multiplex PCR. Diffusion disc tests were performed to determine the antimicrobial susceptibility profile and phenotypic tests for the detection of resistance phenotypes. Next, monoplex PCR was performed to detect 15 genes encoding beta-lactam resistance. The PFGE of P. mirabilis, E. coli and A. baumannii isolates were also performed to verify the genetic similarity between the circulating strains. A total of 526 swabs were collected, of which 134 were patients and 392 were environment. The prevalence of BGN found was 55.3% (291/526), and of these, 219 (75.2%) were identified among the species H. alvei (36.8%), A. baumannii (26.8 %), P. mirabilis (7.6%), P. aeruginosa (2.4%) and E. coli (1.7%). Among the bacteria identified, 51 (23.3%) were resistant to beta-lactams, of which 8 (15.7%) were ESBL-producing. Of the 24 (10.9%) isolates resistant to carbapenems, 10 (41.6%) were carbapenemase producers. The most prevalent beta-lactam resistance genes in the environment samples were blaSHV and blaIMT, both with 39.3%, and blaSME (35.7%). In patients the most prevalent genes were blaSHV (43.5%), blaOXA (39.1%) and blaIMG (34.8%). The dendrograms resulting from the macrorrest profiles show an outbreak of contamination / colonization by a dominant clone of A. baumannii in the ICU in the year 2013 and in 2014 the appearance of different enterobacteria in detriment of A. baumanni revealing the predominance between species in different years. The results suggest that the prevalence of BGN, mainly of enterobacteria, is high in health institutions, mainly in ICUs. The hospital environment can be a potential source of contamination and infection to patients and health professionals, as well as acting as reservoir of resistance genes, deserving greater attention and development of educational and hygienic-sanitary measures to control the patient-environment interface.
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PIRES, C. H. Epidemiologia molecular de bastonetes Gram negativos isolados em uma Unidade de Terapia Intensiva de um hospital escola de Goiânia-GO. 2017. 104 f. Dissertação (Mestrado em Biologia da Relação Parasito-Hospedeiro) - Universidade Federal de Goiás, Goiânia, 2017.