Investigação de genes de resistência a carbapenêmicos e aminoglicosídeos e tipagem molecular de amostras de Acinetobacter baumannii isoladas de pacientes internados em unidades de terapia intensiva de um hospital terciário

• Ano de defesa: 2014
• Autor(a) principal: Polotto, Milena [UNESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Estadual Paulista (Unesp)
• Palavras-chave em Português: Microbiologia; Genetica microbiana; Infecções por Acinetobacter; Resistência microbiana a medicamentos; Tipagem molecular; Antibioticos beta-lactamicos; Microbiology
• Link de acesso: http://hdl.handle.net/11449/122220

The Acinetobacter genus comprises ubiquitous Gram-negative bacilli and its main species, A. calcoaceticus, A. baumannii, A. pittii and A. nosocomialis were grouped in the the Acinetobacter baumannii - Acinetobacter calcoaceticus Complex (ACB Complex) due to their high genetic similarity and for their difficult differentiation by biochemical methods. Most infections caused by ACB complex are pneumonia and bacteremias, and, to treat these, beta-lactams, aminoglycosides and polymyxins are widely used. Nevertheless, beta-lactams and aminoglycosides resistance has been increasing in Acinetobacter spp., mainly, due to the enzymes production called beta-lactamases and aminoglycosides modifying enzymes (AMEs). Thus, the study objectives were to evaluate the antimicrobial susceptibility profile, investigate the carbapenemases gene (blaOXA-23like, blaOXA-51like, blaOXA-58like, blaOXA24-40like, blaOXA-143like, blaOXA-48like, blaKPC, blaGES, blaVIM, blaIMPand blaSPM), the AMEs genes [aac(3)-Ia, aac(3)-II, aac(6’)-Ih, aph(3’)-VI, ant(2’)-Ia, aph(3’)-Ia and aac(6’)-Ib], and to determine the genetic similarity by REP-PCR. One hundred carbapenem resistant isolates of ACB complex were sent to the Microbiology Laboratory of the Faculdade de Medicina de São José do Rio Preto, where DNA extraction, species identification, PCRs and molecular typing by REP-PCR were carried out. All of the isolates showed multidrug resistance phenotype and were identified as A. baumannii. The genes blaOXA-23like and blaOXA-51like were present in 100% of the isolates andISAba1 was “upstream” to the blaOXA-23likegene. The AMES genes detected were aph(3')-VI (55%), aac(6')-Ib (46%), aac(3)-Ia (30%) and aph(3')-Ia (24%). The REP-PCR typing generated five groups (A, B, C, D and E) with 20 clusters. Of these, many were endemic clusters, because they were isolated during all the collection period and in all the HB´s ICUs. Furthermore, the horizontal transmission ...