Epidemiology of β-lactamase producing isolates

• Autor(a) principal: Roxo, Inês Abrantes Cravo
• Data de Publicação: 2015
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10773/14879
• topic: Biomedicina molecular; Bactérias gram-negativas; Aparelho urinário - Infecções

Multidrug resistant bacteria are an emerging problem worldwide, associated with prolonged stays in the hospital and inherent increased costs. Widely studied ESBL-producers, and the not so considered AmpC-producers are of extreme importance, and its epidemiology should be closely followed. The epidemiology of ESBL-producing isolates from patients over 65 attending the ER and diagnosed with a UTI, as well as the epidemiology of AmpC-producing isolates were assessed by the Vitek2® procedure of identification. For the AmpC positive isolates, confirmatory phenotypic test were performed, searching for the presence of an AmpC enzyme. High numbers of ESBL-producing isolates, detected in UTI patients over 65 years old are the main motive of concern, since these are recurrent visitors of hospitals and frequently live in nursing homes, which makes them potential carriers of multiresistant strains. The earlier hospital restricted problem has now become widely spread in the community, and requires further attention. As for the AmpC, although less frequent than ESBLs, its presence often masks the ESBL phenotype. Misevaluation and false reports induces wrong medication procedures and the consequent emergence of selected resistant strains. Also, the possibility of identifying both resistance mechanisms in one organism has become more common, rising the need of complementary methods to distinguish them, which the automated method is unable to do. Cefoxitin disc was found to be the right complementary test to perform in order to detect these kinds of multiresistant strains. xii This study shows the importance of following the epidemiology of β-lactamases, providing a realistic view on its dissemination trough the community and its implications in the health care system in our region.