Epidemiologia e caracterização molecular de Pseudomonas aeruginosa, Klebsiella pneumoniae e Escherichia coli multirresistentes carreando determinantes de resistência às quinolonas mediada por plasmídeos
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFU |
Texto Completo: | https://repositorio.ufu.br/handle/123456789/16731 http://doi.org/10.14393/ufu.di.2016.77 |
Resumo: | The study conducted was comprehensive, including classical epidemiology and molecular aspects of infections by P. aeruginosa, K. pneumoniae and E. coli resistant to fluoroquinolones and/or carbapenems. Molecular analysis included determining the profile clonal, identification of genes of interest by PCR-based assays and sequencing of target gene. Case-control study was conducted to evaluate the prognostic and the impact of inappropriate therapy in patients with bacteremia and VAP (ventilator-associated pneumonia), as well as for the determination of the risk factors by multiresistant (MDR) P. aeruginosa infections. We observed a high rate of MDR P. aeruginosa isolates (40.7%), being 51.0% independently associated with inappropriate antibiotic therapy. In patients with VAP, significant rates were related to inappropriate therapy, especially by MDR and resistant to fluoroquinolones isolates. Besides, bacteremia was detected in 66.9% of patients, and prolonged hospital stay was expressive in those resistant to fluoroquinolone. Plasmid-mediated quinolone resistance genes (PMQR), were detected in two (5.3%) nosocomial isolates of P. aeruginosa (qnrS1 and aac(6 )Ib-cr), while those of K. pneumoniae and E. coli, from community or nosocomial origin, the presence of this gene was higher (55.3%; qnrA, qnrB, qnrD, qnrS and aac(6 )Ib-cr). In addition, we could verify the presence of the aac(6 )-Ib7 variant, with significant frequency to those of P. aeruginosa. Independently of the presence of PMQR genes, the minimum inhibitory concentration (MIC50 and MIC90) for ciprofloxacin were high, as well as, a high frequency of MDR isolates, and among those of the Enterobacteriaceae family were mainly community-acquired infection s agents (55.0%) and urinary tract (72.9%). Most isolates (90%) showed class 1 integron, but there is the necessity of further investigation to determine its relationship with PMQR genes. There was detection of genes encoding metallo-β-lactamase in 21.9% of the P. aeruginosa isolates, predominantly blaSPM gene and a polyclonal profile. Moreover, there was not a prevalent clone associated with the presence of PMQR determinants. Our data show for the first time the presence of PMQR determinants in clinical isolates of P. aeruginosa in Brazil, with a higher frequency of patients with inappropriate therapy; and multidrug-resistant K. pneumoniae and E. coli isolates with plasmid-mediated quinolone resistance. Although studies of classical and molecular epidemiology in hospitals are very important in the country, it is necessary that the infection control practices result in reducing these infections based on this data, considering the additional burden of participation of MDR micro-organism and its importance in terms of morbidity, mortality and cost. |
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2016-06-22T18:46:44Z2016-03-012016-06-22T18:46:44Z2016-02-19ARAÚJO, Bruna Fuga. Epidemiologia e caracterização molecular de Pseudomonas aeruginosa, Klebsiella pneumoniae e Escherichia coli multirresistentes carreando determinantes de resistência às quinolonas mediada por plasmídeos. 2016. 103 f. Dissertação (Mestrado em Ciências Biológicas) - Universidade Federal de Uberlândia, Uberlândia, 2016. Disponível em: http://doi.org/10.14393/ufu.di.2016.77https://repositorio.ufu.br/handle/123456789/16731http://doi.org/10.14393/ufu.di.2016.77The study conducted was comprehensive, including classical epidemiology and molecular aspects of infections by P. aeruginosa, K. pneumoniae and E. coli resistant to fluoroquinolones and/or carbapenems. Molecular analysis included determining the profile clonal, identification of genes of interest by PCR-based assays and sequencing of target gene. Case-control study was conducted to evaluate the prognostic and the impact of inappropriate therapy in patients with bacteremia and VAP (ventilator-associated pneumonia), as well as for the determination of the risk factors by multiresistant (MDR) P. aeruginosa infections. We observed a high rate of MDR P. aeruginosa isolates (40.7%), being 51.0% independently associated with inappropriate antibiotic therapy. In patients with VAP, significant rates were related to inappropriate therapy, especially by MDR and resistant to fluoroquinolones isolates. Besides, bacteremia was detected in 66.9% of patients, and prolonged hospital stay was expressive in those resistant to fluoroquinolone. Plasmid-mediated quinolone resistance genes (PMQR), were detected in two (5.3%) nosocomial isolates of P. aeruginosa (qnrS1 and aac(6 )Ib-cr), while those of K. pneumoniae and E. coli, from community or nosocomial origin, the presence of this gene was higher (55.3%; qnrA, qnrB, qnrD, qnrS and aac(6 )Ib-cr). In addition, we could verify the presence of the aac(6 )-Ib7 variant, with significant frequency to those of P. aeruginosa. Independently of the presence of PMQR genes, the minimum inhibitory concentration (MIC50 and MIC90) for ciprofloxacin were high, as well as, a high frequency of MDR isolates, and among those of the Enterobacteriaceae family were mainly community-acquired infection s agents (55.0%) and urinary tract (72.9%). Most isolates (90%) showed class 1 integron, but there is the necessity of further investigation to determine its relationship with PMQR genes. There was detection of genes encoding metallo-β-lactamase in 21.9% of the P. aeruginosa isolates, predominantly blaSPM gene and a polyclonal profile. Moreover, there was not a prevalent clone associated with the presence of PMQR determinants. Our data show for the first time the presence of PMQR determinants in clinical isolates of P. aeruginosa in Brazil, with a higher frequency of patients with inappropriate therapy; and multidrug-resistant K. pneumoniae and E. coli isolates with plasmid-mediated quinolone resistance. Although studies of classical and molecular epidemiology in hospitals are very important in the country, it is necessary that the infection control practices result in reducing these infections based on this data, considering the additional burden of participation of MDR micro-organism and its importance in terms of morbidity, mortality and cost.O estudo realizado foi abrangente incluindo aspectos de epidemiologia clássica e molecular de infecções por Pseudomonas aeruginosa, Klebsiella pneumoniae e Escherichia coli resistentes às fluoroquinolonas e/ou carbapenêmicos. A análise molecular incluiu a determinação do perfil clonal, identificação de genes de interesse através de ensaios baseados em PCR e sequenciamento de genes alvo. Um estudo caso-controle foi realizado para avaliar o prognóstico e o impacto da terapia inapropriada nos pacientes com bacteremia e PAV (Pneumonia associada à ventilação mecânica), bem como para a determinação dos fatores de risco associados às infecções por P. aeruginosa multirresistente (MDR). Observou-se frequência elevada de amostras de P. aeruginosa MDR (40,7%), sendo 51,0% dos isolados independentemente associados com terapia antimicrobiana inapropriada. Em pacientes com PAV, frequências significantes foram relacionadas à terapia inapropriada, principalmente quando por amostras MDR e resistentes às fluoroquinolonas. Além disso, bacteremia foi detectada em 66,9% dos pacientes, e o tempo de internação hospitalar foi mais prolongado quando as infecções foram por amostras resistentes às fluoroquinolonas. Determinantes de resistência às quinolonas mediada por plasmídeo (PMQR) foram detectados em duas (5,3%) amostras hospitalares de P. aeruginosa (qnrS1 e aac(6 )Ib-cr), enquanto que naqueles de K. pneumoniae e E. coli hospitalares ou comunitários a presença desse gene foi mais alta (55,3%; qnrA, qnrB, qnrD, qnrS e aac(6 )Ib-cr). Adicionalmente, foi possível verificar a presença da variante aac(6 )-Ib7, com frequência expressiva para aqueles de P. aeruginosa. Independentemente da presença de genes PMQR as concentrações inibitórias mínimas (CIM50 e CIM90) para ciprofloxacina foram elevadas, assim como uma alta frequência de amostras MDR, e aqueles da família Enterobacteriaceae foram principalmente agentes de infecções comunitárias (55,0%) e do trato urinário (72,9%). A maioria das amostras (90%) apresentou integron de classe 1, mas há necessidade de mais investigações para determinar sua relação com genes PMQR. Houve a detecção de genes que codificam metalo-β-lactamases em P. aeruginosa em 21,9% das amostras, com predominância de blaSPM, e de um perfil policlonal. Além disso, não houve um clone prevalente associado à presença dos determinantes PMQR. Os nossos dados revelam pela primeira vez a presença de determinantes PMQR em amostras clínicas de P. aeruginosa no Brasil, e uma frequência elevada de pacientes com terapia inapropriada; e, de amostras de K. pneumoniae e E. coli multirresistentes, com resistência às fluoroquinolonas mediada por genes plasmidiais. Embora os estudos de epidemiologia clássica e molecular nos hospitais sejam de grande importância no país, é necessário que práticas de controle de infecção resultem na redução destas infecções com base nos mesmos considerando a carga adicional representada pela participação de micro-organismo MDR, e sua importância em termos de morbidade, mortalidade e custos.Fundação de Amparo a Pesquisa do Estado de Minas GeraisMestre em Imunologia e Parasitologia Aplicadasapplication/pdfporUniversidade Federal de UberlândiaPrograma de Pós-graduação em Imunologia e Parasitologia AplicadasUFUBRCiências BiológicasResistência às quinolonas mediada por plasmídeo (do inglês Plasmid-mediated quinolone resistance, PMQR)MultirresistênciaP. aeruginosaK. pneumoniaeE. coliMetalo-B-lactamase (MBL)Pseudomonas aeruginosaPneumoniaPlasmid-mediated quinolone resistance (PMQR)Multidrug-resistanceCNPQ::CIENCIAS BIOLOGICAS::IMUNOLOGIA::IMUNOLOGIA APLICADAEpidemiologia e caracterização molecular de Pseudomonas aeruginosa, Klebsiella pneumoniae e Escherichia coli multirresistentes carreando determinantes de resistência às quinolonas mediada por plasmídeosinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisRibas, Rosineide Marqueshttp://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4773602H1Gontijo Filho, Paulo Pintohttp://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4787872T0Santos, Katia Regina Netto doshttp://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4789400E5Dantas, Raquel Cristina Cavalcantihttp://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4201027A6http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4458879Z4Araújo, Bruna Fugainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFUinstname:Universidade Federal de Uberlândia (UFU)instacron:UFUTHUMBNAILEpidemiologiaCaracterizacaoMolecular.pdf.jpgEpidemiologiaCaracterizacaoMolecular.pdf.jpgGenerated Thumbnailimage/jpeg1164https://repositorio.ufu.br/bitstream/123456789/16731/3/EpidemiologiaCaracterizacaoMolecular.pdf.jpge61c15a5a186986b852997ae9e3bb3a6MD53ORIGINALEpidemiologiaCaracterizacaoMolecular.pdfapplication/pdf3310581https://repositorio.ufu.br/bitstream/123456789/16731/1/EpidemiologiaCaracterizacaoMolecular.pdffad2de6bca4cf96ef43e34a3cd5e7090MD51TEXTEpidemiologiaCaracterizacaoMolecular.pdf.txtEpidemiologiaCaracterizacaoMolecular.pdf.txtExtracted texttext/plain180144https://repositorio.ufu.br/bitstream/123456789/16731/2/EpidemiologiaCaracterizacaoMolecular.pdf.txta46bb0fa63a2c07b13e83936a1ee7357MD52123456789/167312020-09-23 16:02:29.018oai:repositorio.ufu.br:123456789/16731Repositório InstitucionalONGhttp://repositorio.ufu.br/oai/requestdiinf@dirbi.ufu.bropendoar:2020-09-23T19:02:29Repositório Institucional da UFU - Universidade Federal de Uberlândia (UFU)false |
dc.title.por.fl_str_mv |
Epidemiologia e caracterização molecular de Pseudomonas aeruginosa, Klebsiella pneumoniae e Escherichia coli multirresistentes carreando determinantes de resistência às quinolonas mediada por plasmídeos |
title |
Epidemiologia e caracterização molecular de Pseudomonas aeruginosa, Klebsiella pneumoniae e Escherichia coli multirresistentes carreando determinantes de resistência às quinolonas mediada por plasmídeos |
spellingShingle |
Epidemiologia e caracterização molecular de Pseudomonas aeruginosa, Klebsiella pneumoniae e Escherichia coli multirresistentes carreando determinantes de resistência às quinolonas mediada por plasmídeos Araújo, Bruna Fuga Resistência às quinolonas mediada por plasmídeo (do inglês Plasmid-mediated quinolone resistance, PMQR) Multirresistência P. aeruginosa K. pneumoniae E. coli Metalo-B-lactamase (MBL) Pseudomonas aeruginosa Pneumonia Plasmid-mediated quinolone resistance (PMQR) Multidrug-resistance CNPQ::CIENCIAS BIOLOGICAS::IMUNOLOGIA::IMUNOLOGIA APLICADA |
title_short |
Epidemiologia e caracterização molecular de Pseudomonas aeruginosa, Klebsiella pneumoniae e Escherichia coli multirresistentes carreando determinantes de resistência às quinolonas mediada por plasmídeos |
title_full |
Epidemiologia e caracterização molecular de Pseudomonas aeruginosa, Klebsiella pneumoniae e Escherichia coli multirresistentes carreando determinantes de resistência às quinolonas mediada por plasmídeos |
title_fullStr |
Epidemiologia e caracterização molecular de Pseudomonas aeruginosa, Klebsiella pneumoniae e Escherichia coli multirresistentes carreando determinantes de resistência às quinolonas mediada por plasmídeos |
title_full_unstemmed |
Epidemiologia e caracterização molecular de Pseudomonas aeruginosa, Klebsiella pneumoniae e Escherichia coli multirresistentes carreando determinantes de resistência às quinolonas mediada por plasmídeos |
title_sort |
Epidemiologia e caracterização molecular de Pseudomonas aeruginosa, Klebsiella pneumoniae e Escherichia coli multirresistentes carreando determinantes de resistência às quinolonas mediada por plasmídeos |
author |
Araújo, Bruna Fuga |
author_facet |
Araújo, Bruna Fuga |
author_role |
author |
dc.contributor.advisor-co1.fl_str_mv |
Ribas, Rosineide Marques |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4773602H1 |
dc.contributor.advisor1.fl_str_mv |
Gontijo Filho, Paulo Pinto |
dc.contributor.advisor1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4787872T0 |
dc.contributor.referee1.fl_str_mv |
Santos, Katia Regina Netto dos |
dc.contributor.referee1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4789400E5 |
dc.contributor.referee2.fl_str_mv |
Dantas, Raquel Cristina Cavalcanti |
dc.contributor.referee2Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4201027A6 |
dc.contributor.authorLattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4458879Z4 |
dc.contributor.author.fl_str_mv |
Araújo, Bruna Fuga |
contributor_str_mv |
Ribas, Rosineide Marques Gontijo Filho, Paulo Pinto Santos, Katia Regina Netto dos Dantas, Raquel Cristina Cavalcanti |
dc.subject.por.fl_str_mv |
Resistência às quinolonas mediada por plasmídeo (do inglês Plasmid-mediated quinolone resistance, PMQR) Multirresistência P. aeruginosa K. pneumoniae E. coli Metalo-B-lactamase (MBL) Pseudomonas aeruginosa Pneumonia |
topic |
Resistência às quinolonas mediada por plasmídeo (do inglês Plasmid-mediated quinolone resistance, PMQR) Multirresistência P. aeruginosa K. pneumoniae E. coli Metalo-B-lactamase (MBL) Pseudomonas aeruginosa Pneumonia Plasmid-mediated quinolone resistance (PMQR) Multidrug-resistance CNPQ::CIENCIAS BIOLOGICAS::IMUNOLOGIA::IMUNOLOGIA APLICADA |
dc.subject.eng.fl_str_mv |
Plasmid-mediated quinolone resistance (PMQR) Multidrug-resistance |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS BIOLOGICAS::IMUNOLOGIA::IMUNOLOGIA APLICADA |
description |
The study conducted was comprehensive, including classical epidemiology and molecular aspects of infections by P. aeruginosa, K. pneumoniae and E. coli resistant to fluoroquinolones and/or carbapenems. Molecular analysis included determining the profile clonal, identification of genes of interest by PCR-based assays and sequencing of target gene. Case-control study was conducted to evaluate the prognostic and the impact of inappropriate therapy in patients with bacteremia and VAP (ventilator-associated pneumonia), as well as for the determination of the risk factors by multiresistant (MDR) P. aeruginosa infections. We observed a high rate of MDR P. aeruginosa isolates (40.7%), being 51.0% independently associated with inappropriate antibiotic therapy. In patients with VAP, significant rates were related to inappropriate therapy, especially by MDR and resistant to fluoroquinolones isolates. Besides, bacteremia was detected in 66.9% of patients, and prolonged hospital stay was expressive in those resistant to fluoroquinolone. Plasmid-mediated quinolone resistance genes (PMQR), were detected in two (5.3%) nosocomial isolates of P. aeruginosa (qnrS1 and aac(6 )Ib-cr), while those of K. pneumoniae and E. coli, from community or nosocomial origin, the presence of this gene was higher (55.3%; qnrA, qnrB, qnrD, qnrS and aac(6 )Ib-cr). In addition, we could verify the presence of the aac(6 )-Ib7 variant, with significant frequency to those of P. aeruginosa. Independently of the presence of PMQR genes, the minimum inhibitory concentration (MIC50 and MIC90) for ciprofloxacin were high, as well as, a high frequency of MDR isolates, and among those of the Enterobacteriaceae family were mainly community-acquired infection s agents (55.0%) and urinary tract (72.9%). Most isolates (90%) showed class 1 integron, but there is the necessity of further investigation to determine its relationship with PMQR genes. There was detection of genes encoding metallo-β-lactamase in 21.9% of the P. aeruginosa isolates, predominantly blaSPM gene and a polyclonal profile. Moreover, there was not a prevalent clone associated with the presence of PMQR determinants. Our data show for the first time the presence of PMQR determinants in clinical isolates of P. aeruginosa in Brazil, with a higher frequency of patients with inappropriate therapy; and multidrug-resistant K. pneumoniae and E. coli isolates with plasmid-mediated quinolone resistance. Although studies of classical and molecular epidemiology in hospitals are very important in the country, it is necessary that the infection control practices result in reducing these infections based on this data, considering the additional burden of participation of MDR micro-organism and its importance in terms of morbidity, mortality and cost. |
publishDate |
2016 |
dc.date.accessioned.fl_str_mv |
2016-06-22T18:46:44Z |
dc.date.available.fl_str_mv |
2016-03-01 2016-06-22T18:46:44Z |
dc.date.issued.fl_str_mv |
2016-02-19 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
ARAÚJO, Bruna Fuga. Epidemiologia e caracterização molecular de Pseudomonas aeruginosa, Klebsiella pneumoniae e Escherichia coli multirresistentes carreando determinantes de resistência às quinolonas mediada por plasmídeos. 2016. 103 f. Dissertação (Mestrado em Ciências Biológicas) - Universidade Federal de Uberlândia, Uberlândia, 2016. Disponível em: http://doi.org/10.14393/ufu.di.2016.77 |
dc.identifier.uri.fl_str_mv |
https://repositorio.ufu.br/handle/123456789/16731 |
dc.identifier.doi.pt_BR.fl_str_mv |
http://doi.org/10.14393/ufu.di.2016.77 |
identifier_str_mv |
ARAÚJO, Bruna Fuga. Epidemiologia e caracterização molecular de Pseudomonas aeruginosa, Klebsiella pneumoniae e Escherichia coli multirresistentes carreando determinantes de resistência às quinolonas mediada por plasmídeos. 2016. 103 f. Dissertação (Mestrado em Ciências Biológicas) - Universidade Federal de Uberlândia, Uberlândia, 2016. Disponível em: http://doi.org/10.14393/ufu.di.2016.77 |
url |
https://repositorio.ufu.br/handle/123456789/16731 http://doi.org/10.14393/ufu.di.2016.77 |
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info:eu-repo/semantics/openAccess |
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Universidade Federal de Uberlândia |
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Programa de Pós-graduação em Imunologia e Parasitologia Aplicadas |
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UFU |
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BR |
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Ciências Biológicas |
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Universidade Federal de Uberlândia |
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