Epidemiologia molecular e caracterização da resistência de amostras de Acinetobacter baumannii e Pseudomonas aeruginosa resistentes aos carbapenêmicos provenientes de hospitais da grande Vitória-ES

• Ano de defesa: 2017
• Autor(a) principal: Vallorini, Thalita Pereira Cabral
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Espírito Santo; BR; Mestrado em Ciências Farmacêuticas; Centro de Ciências da Saúde; UFES; Programa de Pós-Graduação em Ciências Farmacêuticas
• Palavras-chave em Português: Resistance; Genotyping; Acinetobacter baumannii; Pseudomonas aeruginosa; Betalactamases; Resistência; Genotipagem; Epidemiologia molecular; Hospitais; Fármacos; Farmácia; 61
• Link de acesso: http://repositorio.ufes.br/handle/10/8357

The emergence and spread of antimicrobial resistance among non-fermenting Gram-negative bacilli, such as Acinetobacter baumannii and Pseudomonas aeruginosa, is a worldwide problem. Carbapenems are beta-lactam antimicrobials indicated for the treatment of serious infections caused by these agents, however, the emergence of multiresistant pathogens seriously threatens the use of this class of drug in the hospital environment. The present work aimed to characterize clinical samples of P. aeruginosa and A. baumannii resistant to cabapenems, as well as the presence of beta-lactam resistance genes, epidemiological profile and susceptibility to antimicrobials used in clinical routine. The antimicrobial susceptibility was performed by disc diffusion and antimicrobial gradient tests. PCR was used to the detection of beta-lactamases-encoding genes and the genetic polymorphism was analyzed by pulsed field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) techniques. The species included in this study were: A. baumannii (n = 26) and P. aeruginosa (n = 15). The most of the isolates presented a multiresistance profile to the tested antimicrobials, highlighting the resistance to colistin in nine isolates of A. baumannii. Among the A. baumannii isolates, the prevalent carbapenemase gene (92.3%) was blaOXA-23 and in P. aeruginosa isolates the blaVIM gene was prevalent (33.3%). The PFGE analysis showed the prevalence of two pulsotypes among the A. baumannii: abA (34.6%) and abB (23%), while the P. aeruginosa isolates presented distinct pulsotypes, demonstrating the polyclonal origin of isolates. MLST was performed in five isolates of P. aeruginosa presenting different pulsotypes and STs 357, 2321, 1121, 244 and 227 were found, with two clonal complexes of world importance: CC235 and CC244. In addition, ST357, ST2321 and ST1121 were described for the first time in Brazil.