Caracterização fenotípica e molecular de Enterococcus isolados de infecções da corrente sanguínea

• Autor(a) principal: Araújo, Luciana Milanêz de Paula
• Data de Publicação: 2017
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/14462
• topic: Enterococcus; Blood stream infections; Bacteremia; PFGE; Vancomycin- resistant Enterococcus; Multiresistance; Enterococcus; Infecções de corrente sanguínea; Bacteremia; PFGE; Enterococcus resistentes a vancomicina; Multirresistência; Enterococcus; Circulação sanguínea Infecção; Virulência (Microbiologia); Infecção hospitalar; Resistência microbiana a medicamentos; CNPQ::CIENCIAS BIOLOGICAS::MICROBIOLOGIA::MICROBIOLOGIA APLICADA

Nosocomial blood stream infections (BSIs) are a common and potentially life-threatening problem in intensive care units and are among the most frequently documented nosocomial infections. They are classified according to specific features related to diagnostic and preventive aspects.In addition, the prolonged use of intravascular catheters and its inadequate management are important risk factors for nosocomial BSIs development. Besides, respiratory, urinary tract, wounds, and gastrointestinal infections may also contribute as a primary focus for BSIs development. In this setting, enterococci emerged as important pathogens and are currently considered the third most common cause of nosocomial bacteremia. Among the Enterococcus species, E. faecalis is the most frequent, followed by E. faecium. The aim of this study was to perform the phenotypic and molecular characterization of enterococci isolated from bloodstream of hospitalized patients attended at healthcare instituitions located in two Brazilian states (Rio de Janeiro and Rio Gende do Norte), in a 11 years period (from 2005 to 2015). This study included 203 isolates that were characterized as genus and species level by MALDI-TOF. Susceptibility testing were carried out by disk diffusion to a panel of 15 antimicrobial agents and vancomycin-resistance genotype were detected by PCR. Virulence profiles were investigated by PCR for a set of nine genes. The diversity of de the isolates belonging to E. faecalis and E. faecium species were determined by PFGE technique. The results of this study identifiedthe prevalence of E. faecalis species followed by E. faecium. However, isolates belonging E. avium, E. gallinarum, E. durans and E. raffinosus were also identified. A large amout of multidrug resistance isolates were detected. Resistance to quinolones, macrolides and tetracyclines were prevalent. A high prevalence of isolates non-susceptible to antimicrobials commonly used to the BSIs therapy such as aminoglycosides, beta-lactams and glycopeptides were also identified. E. faecalis showed virulence determinants in higher frequency than E. faecium. Vancomycin resistance was associated to esp and hyl among E. faecium isolates. PFGE results showed a greater diversity among E. faecalis than E. faecium. Clonal groups included isolated from different healthcare institutions suggesting a wide interhospitalar dispersion. The information presented in this study are intended to contribute to brazilian data as an additional support for the development of control measures of the dispersion of Enterococcus resistant strains as well as for the improvement of BSIs management.