Caracterização molecular de amostras de Pseudomonas aeruginosa resistentes a Amicacina e Meropenem

• Ano de defesa: 2019
• Autor(a) principal: Santos, Paulo Henrique Dantas Dos [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Pseudomonas Aeruginosa; Resistência Antimicrobiana; Amicacina; Meropenem; Infecção; Tratamento
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7590746; https://repositorio.unifesp.br/handle/11600/59222

Introduction: Pseudomonas aeruginosa infections in the hospital environment present high morbidity and mortality, particularly in immunocompromised patients, with high rates of multiresistance to antimicrobials including carbapenens and aminoglycosides. This study retrospectively analyzed isolates of P. aeruginosa resistant to amikacin and meropenem from nosocomial infections of the bloodstream and respiratory tract diagnosed in the participating medical centers of SCOPE Brazil and Hospital São Paulo. Methods: The sensitivity profile to amikacin and meropenem of 96 P. aeruginosa samples, identified by MALDI-TOF, was determined by dilution in agar. The presence of genes encoding enzyme resistance to meropenem and amikacin was evaluated by real-time PCR (qPCR) and the clonality profile by Pulsed Field Gel Electrophoresis (PFGE). Four samples with different minimum inhibitory concentrations (MIC) for amikacin were submitted to new generation sequencing (SNG). Results: Resistance to both antibiotics, amikacin and meropenem, was observed in 42 (43.75%) with very high MICs for amikacin (> 4,096 μg / ml). The blaSPM, rmtD, blaGES resistance genes were detected by the qPCR methodology. An association of samples with higher MICs for amikacin was observed when the detection of genes coding for the metalloenzyme blaSPM and the methylase rmtD was observed. The analysis of the clonality profile of the isolates resistant to amikacin by PFGE revealed 10 profiles, and the majority of isolates resistant to amikacin and meropenem are found in the same profile. The SNG analyzed by the online platforms Center for Genomic Epidemiology and MLST-Pasteur Database enabled the detection of resistance genes for β-lactams, aminoglycosides and fluoroquinolones, as well as ST of three isolates, especially ST 277 for international dissemination.