ABSTRACT
Objetivo: descrever o perfil epidemiológico de infecções por bactérias do grupo ESKAPE em pacientes internados em uma unidade de terapia intensiva de um hospital de ensino da cidade de Juiz de Fora - MG. Métodos: Trata-se de um estudo epidemiológico observacional, descritivo de caráter retrospectivo, com participantes que adquiriram IRAS entre 2017 e 2018, dos quais foram isoladas e identificadas linhagens bacterianas pertencentes ao grupo ESKAPE no serviço de rotina bacteriológica do laboratório de microbiologia clínica. Resultados: Considerando o fenótipo de multirresistência entre as bactérias do grupo ESKAPE avaliadas, foi observada a ocorrência de 122 (88,4%) para Acinetobacter baumanii resistente aos carbapenêmicos, 87 (60,8%) para Klebsiella pneumoniae resistente aos carbapenêmicos, 57 (53,3%) para Pseudomonas aeruginosa resistente aos carbapenêmicos, 36 (55,4%) para MRSA e 19 (48,7%) para Enterobacter sp. resistente aos carbapenêmicos. Conclusões: A análise do perfil epidemiológico, clínico e microbiológico de infecções por bactérias do grupo ESKAPE em pacientes internados em uma UTI é de majorada importância para protocolos de terapia com o correto manejo de antibioticoterapia e redução da prevalência de resistência antimicrobiana.
Objective: To describe the epidemiological profile of ESKAPE group bacteria infections in patients admitted to an intensive care unit of a teaching hospital in Juiz de Fora, Minas Gerais. Methods: This is an observational, descriptive epidemiological study of retrospective nature, with participants who acquired IRAS between 2017 and 2018, from which bacterial strains belonging to the ESKAPE group were isolated and identified in the bacteriological routine service of the clinical microbiology laboratory. Results: Considering the multidrug resistance phenotype among the ESKAPE group bacteria evaluated, the occurrence of 122 (88.4%) for carbapenem- resistant Acinetobacter baumanii, 87 (60.8%) for carbapenem-resistant Klebsiella pneumoniae, 57 (53.3%) for carbapenem-resistant Pseudomonas aeruginosa, 36 (55.4%) for MRSA, and 19 (48.7%) for carbapenem-resistant Enterobacter sp. was observed. Conclusions: The analysis of the epidemiological, clinical and microbiological profile of infections caused by bacteria of the ESKAPE group in patients in an ICU is of major importance for therapy protocols with the correct management of antibiotic therapy and reduction of the prevalence of antimicrobial resistance.
Objetivo: Describir el perfil epidemiológico de las infecciones por bacterias del grupo ESKAPE en pacientes internados en la unidad de terapia intensiva de un hospital escuela de Juiz de Fora, Minas Gerais. Método: Se trata de un estudio epidemiológico observacional, descriptivo, de carácter retrospectivo, con participantes que adquirieron IRAS entre 2017 y 2018, de los cuales se aislaron e identificaron cepas bacterianas pertenecientes al grupo ESKAPE en el servicio de rutina bacteriológica del laboratorio de microbiología clínica. Resultados: Considerando el fenotipo de resistencia a múltiples fármacos entre las bacterias del grupo ESKAPE evaluadas, se observó la ocurrencia de 122 (88,4%) para Acinetobacter baumanii resistente a carbapenemes, 87 (60,8%) para Klebsiella pneumoniae resistente a carbapenemes, 57 (53,3%) para Pseudomonas aeruginosa resistente a carbapenemes, 36 (55,4%) para MRSA y 19 (48,7%) para Enterobacter sp. resistente a carbapenemes. Conclusiones: El análisis del perfil epidemiológico, clínico y microbiológico de las infecciones causadas por bacterias del grupo ESKAPE en pacientes ingresados en una UCI es de gran importancia para los protocolos terapéuticos con el correcto manejo de la antibioticoterapia y la reducción de la prevalencia de resistencias antimicrobianas.
ABSTRACT
Abstract INTRODUCTION Staphylococcus aureus is a major nosocomial pathogen that is associated with high virulence and the rapid development of drug resistance. METHODS We analyzed and compared the antimicrobial resistance, virulence profiles, and molecular epidemiology of 67 S. aureus strains, including 36 methicillin-sensitive (MSSA) and 31 methicillin-resistant (MRSA) strains recovered from a public hospital located in south-eastern Brazil. RESULTS The clones circulating in this hospital presented a great diversity, and the majority of the strains were related to clones responsible for causing worldwide epidemics: these included USA100 (New York/Japan clone), USA300, and USA600. The 31 MRSA (22 SCCmecII and 9 SCCmecIV) and 36 MSSA strains exhibited low resistance against gentamicin and trimethoprim/sulfamethoxazole. No MRSA strain showed resistance to tetracycline. Virulence gene carriage was more diverse and abundant in MSSA than in MRSA. Of the evaluated adhesion-related genes, ebpS was the most prevalent in both MSSA and MRSA strains. The genes bbp and cna showed a strong association with MSSA strains. CONCLUSIONS Our findings reinforce the idea that MSSA and MRSA strains should be carefully monitored, owing to their high pathogenic potential.
Subject(s)
Humans , Staphylococcus aureus/drug effects , Staphylococcus aureus/genetics , Methicillin Resistance , Virulence Factors/genetics , Methicillin-Resistant Staphylococcus aureus/genetics , Anti-Bacterial Agents/pharmacology , Staphylococcal Infections/epidemiology , Staphylococcus aureus/isolation & purification , Staphylococcus aureus/classification , Virulence/genetics , Brazil/epidemiology , Microbial Sensitivity Tests , Molecular Epidemiology , Tertiary Care Centers , Hospitals, PublicABSTRACT
Group B Streptococcus (GBS) is still not routinely screened during pregnancy in Brazil, being prophylaxis and empirical treatment based on identification of risk groups. This study aimed to investigate GBS prevalence in Brazilian pregnant women by culture or polymerase chain reaction (PCR) associated to the enrichment culture, and to determine the antimicrobial susceptibility patterns of isolated bacteria, so as to support public health policies and empirical prophylaxis. After an epidemiological survey, vaginal and anorectal specimens were collected from 221 consenting laboring women. Each sample was submitted to enrichment culture and sheep blood agar was used to isolate suggestive GBS. Alternatively, specific PCR was performed from enrichment cultures. Antimicrobial susceptibility patterns were determined for isolated bacteria by agar diffusion method. No risk groups were identified. Considering the culture-based methodology, GBS was detected in 9.5 percent of the donors. Twenty five bacterial strains were isolated and identified. Through the culture-PCR methodology, GBS was detected in 32.6 percent specimens. Bacterial resistance was not detected against ampicillin, cephazolin, vancomycin and ciprofloxacin, whereas 22.7 percent were resistant to erythromycin and 50 percent were resistant to clindamycin. GBS detection may be improved by the association of PCR and enrichment culture. Considering that colony selection in agar plates may be laboring and technician-dependent, it may not reflect the real prevalence of streptococci. As in Brazil prevention strategies to reduce the GBS associated diseases have not been adopted, prospective studies are needed to anchor public health policies especially considering the regional GBS antimicrobial susceptibility patterns.
ABSTRACT
Os resíduos de serviços de saúde suscitam polêmica quanto a importância para a saúde humana, animal e ambiental. Avaliou-se a ocorrência de bactérias clinicamente relevantes na pilha de resíduos de serviços de saúde em um aterro sanitário e seu perfil de susceptibilidade aos antimicrobianos. Alíquotas de chorume foram processadas para isolamento seletivo de Staphylococcus sp, bastonetes Gram negativos da família Enterobacteriaceae e não fermentadores. Resistência bacteriana a todos os antimicrobianos testados foi observada em todos os grupos microbianos, além de resistência a mais de uma droga. Os resultados permitem sugerir que bactérias viáveis nos resíduos de serviços de saúde representam riscos à saúde humana e animal. Além disso, a ocorrência de linhagens multirresistentes sustenta a hipótese dos resíduos de serviços de saúde atuarem como reservatórios de marcadores de resistência, com impacto ambiental. A falta de legislação regional de segregação, tratamento e destino de resíduos podem expor diferentes populações a riscos de transmissão de doenças infecciosas associadas a microrganismos multirresistentes.
Health service waste gives rise to controversy regarding its importance for human, animal and environmental health. Occurrences of clinically relevant bacteria in piles of health service waste in a sanitary landfill and their antimicrobial susceptibility profile were evaluated. Aliquots of leachate were processed for selective isolation of Staphylococcus sp, Gram-negative rods of the Enterobacteriaceae family and non-fermenters. Bacterial resistance to all the antimicrobials tested was observed in all microbial groups, including resistance to more than one drug. The results make it possible to suggest that viable bacteria in health service waste represent risks to human and animal health. Furthermore, occurrences of multiresistant strains support the hypothesis that health service waste acts as a reservoir for resistance markers, with an environmental impact. The lack of regional legislation concerning segregation, treatment and final disposal of waste may expose different populations to risks of transmission of infectious diseases associated with multiresistant microorganisms