Prevalência de bastonetes gram-negativos isolados da nasofaringe de crianças de creches do município de Goiânia
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2007-10-11
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Universidade Federal de Goiás
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Introduction: the nasopharynx (NP) constitutes the primary ecological reservoir or source of
dissemination of microorganisms as Streptococcus pneumoniae, Haemophilus influenzae,
Staphylococcus aureus and Gram-negative bacilli (GNB). Several studies demonstrated that
asymptomatic nasopharyngeal (NP) carriage of pathogens is prevalent in young infants and
precedes the development of invasive disease. Children in day-care centers act as an important
vector for horizontal spread of the respiratory pathogens and GNB within the community. The
infants are susceptible to condition of carrier and take a fundamental role in the epidemiology
of respiratory infections. The nasopharyngeal flora becomes established during the first year
of life and is densely colonized by a broad variety of microorganisms, commensal bacteria as
well as potential pathogens that may cause infections. Epidemiologic studies demonstrate that
many factors influence nasopharyngeal carriage rates: age, gender, season, acute respiratory
illness, exposure to other children, socio-economic status, family size, warm-climate
countries, passive smoking exposure, antibiotic therapy are risk factors of colonization of the
NP by BGN. Objective: this study aimed to determinate the prevalence and susceptibility
pattern of BGN isolated from NP of children less than five years old attending day-care
centers at municipality of Goiânia. Methods: the investigation was conducted in the
municipality of Goiânia as part of an ongoing prospective surveillance of Streptococcus
pneumoniae, Haemophilus influenzae, Staphylococcus aureus in children of 62 day-care
centers. The surveillance was carried out from August to December, 2005 and was collected
1192 samples. The nasopharyngeal specimens were collected with a transwab, extrathin and
flexible, placed in Stuart transport medium tubes and transported to the Laboratory of
Bacteriology of the Federal University of Goias-Institute of Tropical Pathology and Public
Health to processing. The isolates were identified by colony morphology, Gram staining
technique and according to standardized tests. Susceptibility tests were performed by the disk
diffusion method. Results: a total of 106 (8,9%) Gram-negative bacilli were isolated and 13
species were identified. The species more prevalent were twenty-six (24,5%) Enterobacter
aerogenes, seventeen (16,0%) K. pneumoniae, eleven (10,4%) E. coli, eight (7,5%) E.
agglomerans and five (4,7%) Pseudomonas sp. It was observed that forty-three (57,3%) GNB
were resistant to ampicillin; twenty (26,7%) to trimethoprim-sulfametoxazole; eighteen
(24,0%) showed resistance to amoxicillin-clavulanic acid and nine (12,0%) presented
resistance to tetracycline. The production of extended-spectrum beta-lactamase was not
detected. Conclusion: in this study was demonstrated that young children attending in daycare
centers at municipality of Goiania might be GNB carrier and therefore have a
fundamental role in the dissemination of microorganisms involved in community-acquired
infections. It is necessary that more studies be developed to establish strategies more
effectives to minimize the problem of the nasopharyngeal colonization and communityacquired
infections due to importance and seriousness that both represent in the public health.
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LIMA, Ana Beatriz Mori. Prevalence of gram-negative rods isolated from the nasopharynx of children in daycare centers in Goiânia. 2007. 24 f. Dissertação (Mestrado em Medicina) - Universidade Federal de Goiás, Goiânia, 2007.