Epidemiology of β-lactamases producing strains: ESBL, KPC and OXA-48

Detalhes bibliográficos
Autor(a) principal: Ferreira, Inês Margarida Novais
Data de Publicação: 2021
Tipo de documento: Dissertação
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10773/30963
Resumo: The discovery of antibiotics was a turning point in human history, as the health community saw a solution for the treatment of infectious diseases. However, with the increased use and misuse of antibiotics, resistance to them has also increased, and consequently the difficulty in treating infections caused by multi-drug resistant (MDR) microorganisms, both in the hospital settings and the community. The aim of this study was to evaluate the epidemiology of resistance to β-lactams, namely the main resistance mechanisms present in strains of carbapenem-resistant Enterobacteriaceae (CRE) from patients attending the Centro Hospitalar do Baixo Vouga E.P.E. (CHBV), between April 2019 to February 2020. In addition, a nucleic acid extraction protocol was also developed in order to detect resistance genes of interest in the CHBV microbiology laboratory. The results obtained demonstrated the presence of Klebsiella pneumoniae carbapenemase (KPC) in 43 of the 52 carbapenem-resistant isolates analyzed, and mostly in strains of K. pneumoniae (38/52). In addition, the presence of two nosocomial OXA-48 producing strains was also detected, as well as the co-occurrence of resistance to carbapenems with the production of other β-lactamases, namely AmpCs and ESBL. In short, this work emphasizes the emergence of resistant strains in different environments, but mainly at the hospital environment. Thus, there is a clear need and urgency for continued surveillance and epidemiological monitoring regarding MDR strains, as well as awareness of the serious problem of antibiotic resistance among the general community.
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spelling Epidemiology of β-lactamases producing strains: ESBL, KPC and OXA-48Antibiotic resistanceβ-lactam antibioticsEpidemiologyβ-lactamasesK. pneumoniaeKPCOXA-48The discovery of antibiotics was a turning point in human history, as the health community saw a solution for the treatment of infectious diseases. However, with the increased use and misuse of antibiotics, resistance to them has also increased, and consequently the difficulty in treating infections caused by multi-drug resistant (MDR) microorganisms, both in the hospital settings and the community. The aim of this study was to evaluate the epidemiology of resistance to β-lactams, namely the main resistance mechanisms present in strains of carbapenem-resistant Enterobacteriaceae (CRE) from patients attending the Centro Hospitalar do Baixo Vouga E.P.E. (CHBV), between April 2019 to February 2020. In addition, a nucleic acid extraction protocol was also developed in order to detect resistance genes of interest in the CHBV microbiology laboratory. The results obtained demonstrated the presence of Klebsiella pneumoniae carbapenemase (KPC) in 43 of the 52 carbapenem-resistant isolates analyzed, and mostly in strains of K. pneumoniae (38/52). In addition, the presence of two nosocomial OXA-48 producing strains was also detected, as well as the co-occurrence of resistance to carbapenems with the production of other β-lactamases, namely AmpCs and ESBL. In short, this work emphasizes the emergence of resistant strains in different environments, but mainly at the hospital environment. Thus, there is a clear need and urgency for continued surveillance and epidemiological monitoring regarding MDR strains, as well as awareness of the serious problem of antibiotic resistance among the general community.A descoberta dos antibióticos foi um momento muito importante na história da humanidade, pois a comunidade de saúde viu uma solução para o tratamento das doenças infeciosas. No entanto, com o aumento do uso de antibióticos também aumentou a resistência aos mesmos, e consequentemente a dificuldade de tratar infeções causadas por microrganismos multirresistentes (MDR), tanto em ambiente hospitalar como na comunidade. O principal objetivo deste estudo passa por avaliar a epidemiologia da resistência aos β-lactâmicos, nomeadamente os principais mecanismos de resistência presentes em estirpes de Enterobacteriaceae resistentes aos carbapenemos (ERC) de utentes do Centro Hospitalar do Baixo Vouga E.P.E (CHBV), entre abril de 2019 e fevereiro de 2020. Além disso, foi também desenvolvido um protocolo de extração de ácidos nucleicos com o intuito de deteção de genes de resistência de interesse no laboratório de microbiologia do CHBV. Os resultados obtidos demonstram a presença da Klebsiella pneumoniae carbapenemase (KPC) em 43 dos 52 isolados resistentes a carbapenemos analisados, e maioritariamente em estirpes de K. pneumoniae (38/52). Para além disto, foi também detetada a presença de duas estirpes produtoras de OXA-48 em ambiente hospitalar, bem como a co-ocorrência da resistência a carbapenemos com a produção de outras β-lactamases, nomeadamente AmpCs e ESBL. Em suma, este trabalho enfatiza a emergência de estirpes resistentes em diferentes ambientes, mas principalmente a nível hospitalar. Assim, é notória a necessidade e urgência de monotorização e controle epidemiológico em relação às estirpes multirresistentes, bem como a sensibilização em relação ao grave problema da resistência aos antibióticos entre a comunidade geral.2023-03-11T00:00:00Z2021-02-25T00:00:00Z2021-02-25info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttp://hdl.handle.net/10773/30963engFerreira, Inês Margarida Novaisinfo:eu-repo/semantics/embargoedAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-02-22T11:59:51Zoai:ria.ua.pt:10773/30963Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:02:58.510521Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Epidemiology of β-lactamases producing strains: ESBL, KPC and OXA-48
title Epidemiology of β-lactamases producing strains: ESBL, KPC and OXA-48
spellingShingle Epidemiology of β-lactamases producing strains: ESBL, KPC and OXA-48
Ferreira, Inês Margarida Novais
Antibiotic resistance
β-lactam antibiotics
Epidemiology
β-lactamases
K. pneumoniae
KPC
OXA-48
title_short Epidemiology of β-lactamases producing strains: ESBL, KPC and OXA-48
title_full Epidemiology of β-lactamases producing strains: ESBL, KPC and OXA-48
title_fullStr Epidemiology of β-lactamases producing strains: ESBL, KPC and OXA-48
title_full_unstemmed Epidemiology of β-lactamases producing strains: ESBL, KPC and OXA-48
title_sort Epidemiology of β-lactamases producing strains: ESBL, KPC and OXA-48
author Ferreira, Inês Margarida Novais
author_facet Ferreira, Inês Margarida Novais
author_role author
dc.contributor.author.fl_str_mv Ferreira, Inês Margarida Novais
dc.subject.por.fl_str_mv Antibiotic resistance
β-lactam antibiotics
Epidemiology
β-lactamases
K. pneumoniae
KPC
OXA-48
topic Antibiotic resistance
β-lactam antibiotics
Epidemiology
β-lactamases
K. pneumoniae
KPC
OXA-48
description The discovery of antibiotics was a turning point in human history, as the health community saw a solution for the treatment of infectious diseases. However, with the increased use and misuse of antibiotics, resistance to them has also increased, and consequently the difficulty in treating infections caused by multi-drug resistant (MDR) microorganisms, both in the hospital settings and the community. The aim of this study was to evaluate the epidemiology of resistance to β-lactams, namely the main resistance mechanisms present in strains of carbapenem-resistant Enterobacteriaceae (CRE) from patients attending the Centro Hospitalar do Baixo Vouga E.P.E. (CHBV), between April 2019 to February 2020. In addition, a nucleic acid extraction protocol was also developed in order to detect resistance genes of interest in the CHBV microbiology laboratory. The results obtained demonstrated the presence of Klebsiella pneumoniae carbapenemase (KPC) in 43 of the 52 carbapenem-resistant isolates analyzed, and mostly in strains of K. pneumoniae (38/52). In addition, the presence of two nosocomial OXA-48 producing strains was also detected, as well as the co-occurrence of resistance to carbapenems with the production of other β-lactamases, namely AmpCs and ESBL. In short, this work emphasizes the emergence of resistant strains in different environments, but mainly at the hospital environment. Thus, there is a clear need and urgency for continued surveillance and epidemiological monitoring regarding MDR strains, as well as awareness of the serious problem of antibiotic resistance among the general community.
publishDate 2021
dc.date.none.fl_str_mv 2021-02-25T00:00:00Z
2021-02-25
2023-03-11T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
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status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10773/30963
url http://hdl.handle.net/10773/30963
dc.language.iso.fl_str_mv eng
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instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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