Susceptibilidade aos antibióticos e aos biocidas clorexidina e cloreto de benzalcônio em isolados clínicos de Acinetobacter baumannii
Acinetobacter baumannii species stands the main pathogens involved in hospital-acquired infection (HAI) in hospitalized patients, particularly in Intensive Care Units (ICUs), and has a great capacity to acquire antimicrobial resistance mechanisms. Recently, the reduction of susceptibility to bioc...
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Acinetobacter baumannii Multirresistência Biocidas qacE blaOXA-23 CNPQ::CIENCIAS BIOLOGICAS |
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Acinetobacter baumannii Multirresistência Biocidas qacE blaOXA-23 CNPQ::CIENCIAS BIOLOGICAS Évora, Bruna Helena Silva Rendall Susceptibilidade aos antibióticos e aos biocidas clorexidina e cloreto de benzalcônio em isolados clínicos de Acinetobacter baumannii |
| description |
Acinetobacter baumannii species stands the main pathogens involved in hospital-acquired
infection (HAI) in hospitalized patients, particularly in Intensive Care Units (ICUs), and has a
great capacity to acquire antimicrobial resistance mechanisms. Recently, the reduction of
susceptibility to biocides as antiseptics and disinfectants has been reported in many species,
including A. baumannii. The aim of the present study was to determine the susceptibility
profile to antibiotics and to the biocides chlorhexidine and benzalkonium chloride
susceptibility profile of clinical isolates of A. baumannii from general hospitals in the city of
Natal, Rio Grande do Norte, Brazil. The samples were collected among March 2013 to March
2014, identified through conventional biochemical tests, confirmed by the blaOXA-51 gene and
MALDI-TOF system, and stored in a freezer at -20 ° C in the Laboratório de Bacteriologia
Médica (LaBMed), UFRN. The susceptibility of 135 samples of A. baumannii to antibiotics
commonly used in clinical practice was evaluated by the disc diffusion method (kirby-bauer)
and by EDTA (ethylenediaminetetraacetic acid) combined disk test. The susceptibility to
biocides was evaluated by determination of the Minimum Inhibitory Concentration (MIC) by
using the broth microdilution method, according to CLSI recommendations. In addition, the
Polymerase Chain Reaction (PCR) assay was used for the detection of genes encoding the
carbapenemases IMP-1, VIM-1, NDM-1, and OXA-23, 24, 58, 143 and the efflux pumps QacE,
AdeB and AdeJ. The multidrug resistance (MDR) profile was observed in 70,37% (95/135) of
the isolates and 44,21% (42/95) were extensively resistant (XDR) since they were resistant to
all antibiotics, except for Tigecycline, whose resistance was observed in only one isolate.
Resistance to carbapenems was detected in 71.85% (97/135) of the isolates. Seventy seven
isolates were positive for metallo-betalactamases (MBLs) and just the NDM-1 and IMP-1
enzymes were detected in 15,85% and 2,06% on these isolates, respectively. The blaOXA-23
(90%) and blaOXA-143 (28%) genes were the most prevalent. Regarding the biocides
susceptibility assessment, 19,25% (26/135) isolates presented reduced sensitivity to
chlorhexidine and 40% (54/135) to benzalkonium chloride. The adeB and adeJ genes were
detected in almost all isolates corresponding to 115 (85.19%) and 129 (95.85%), respectively,
although this results did not show a positive association with tolerance to the biocides tested,
statistically (p<0,05). However, qacE gene showed a significant relationship (p=0, 0006) with
the susceptibility reduced to chlorhexidine, being present in 46,15% (12/26) of the isolates
less susceptible to this compound. Another significant association was observed between the
reductions of susceptibility to benzalkonium chloride and the multirresistance profile of the
isolates. This research describes strains of A. baumannii with a resistance profile that greatly
compromises the treatment of infections by this microorganism, as well as limits the agents
used in the hospital sanitization and disinfection process. There should therefore be
permanent surveillance of cross-transmission in hospital settings and seek the use of more
effective biocides. |
| author2 |
Melo, Maria Celeste Nunes de |
| author_facet |
Melo, Maria Celeste Nunes de Évora, Bruna Helena Silva Rendall |
| format |
masterThesis |
| author |
Évora, Bruna Helena Silva Rendall |
| author_sort |
Évora, Bruna Helena Silva Rendall |
| title |
Susceptibilidade aos antibióticos e aos biocidas clorexidina e cloreto de benzalcônio em isolados clínicos de Acinetobacter baumannii |
| title_short |
Susceptibilidade aos antibióticos e aos biocidas clorexidina e cloreto de benzalcônio em isolados clínicos de Acinetobacter baumannii |
| title_full |
Susceptibilidade aos antibióticos e aos biocidas clorexidina e cloreto de benzalcônio em isolados clínicos de Acinetobacter baumannii |
| title_fullStr |
Susceptibilidade aos antibióticos e aos biocidas clorexidina e cloreto de benzalcônio em isolados clínicos de Acinetobacter baumannii |
| title_full_unstemmed |
Susceptibilidade aos antibióticos e aos biocidas clorexidina e cloreto de benzalcônio em isolados clínicos de Acinetobacter baumannii |
| title_sort |
susceptibilidade aos antibióticos e aos biocidas clorexidina e cloreto de benzalcônio em isolados clínicos de acinetobacter baumannii |
| publisher |
Brasil |
| publishDate |
2019 |
| url |
https://repositorio.ufrn.br/jspui/handle/123456789/26853 |
| work_keys_str_mv |
AT evorabrunahelenasilvarendall susceptibilidadeaosantibioticoseaosbiocidasclorexidinaecloretodebenzalconioemisoladosclinicosdeacinetobacterbaumannii |
| _version_ |
1773961989729550336 |
| spelling |
ri-123456789-268532019-05-26T05:18:12Z Susceptibilidade aos antibióticos e aos biocidas clorexidina e cloreto de benzalcônio em isolados clínicos de Acinetobacter baumannii Évora, Bruna Helena Silva Rendall Melo, Maria Celeste Nunes de Fernandes, José Veríssimo Almeida, Gilmara Celli Maia de Acinetobacter baumannii Multirresistência Biocidas qacE blaOXA-23 CNPQ::CIENCIAS BIOLOGICAS Acinetobacter baumannii species stands the main pathogens involved in hospital-acquired infection (HAI) in hospitalized patients, particularly in Intensive Care Units (ICUs), and has a great capacity to acquire antimicrobial resistance mechanisms. Recently, the reduction of susceptibility to biocides as antiseptics and disinfectants has been reported in many species, including A. baumannii. The aim of the present study was to determine the susceptibility profile to antibiotics and to the biocides chlorhexidine and benzalkonium chloride susceptibility profile of clinical isolates of A. baumannii from general hospitals in the city of Natal, Rio Grande do Norte, Brazil. The samples were collected among March 2013 to March 2014, identified through conventional biochemical tests, confirmed by the blaOXA-51 gene and MALDI-TOF system, and stored in a freezer at -20 ° C in the Laboratório de Bacteriologia Médica (LaBMed), UFRN. The susceptibility of 135 samples of A. baumannii to antibiotics commonly used in clinical practice was evaluated by the disc diffusion method (kirby-bauer) and by EDTA (ethylenediaminetetraacetic acid) combined disk test. The susceptibility to biocides was evaluated by determination of the Minimum Inhibitory Concentration (MIC) by using the broth microdilution method, according to CLSI recommendations. In addition, the Polymerase Chain Reaction (PCR) assay was used for the detection of genes encoding the carbapenemases IMP-1, VIM-1, NDM-1, and OXA-23, 24, 58, 143 and the efflux pumps QacE, AdeB and AdeJ. The multidrug resistance (MDR) profile was observed in 70,37% (95/135) of the isolates and 44,21% (42/95) were extensively resistant (XDR) since they were resistant to all antibiotics, except for Tigecycline, whose resistance was observed in only one isolate. Resistance to carbapenems was detected in 71.85% (97/135) of the isolates. Seventy seven isolates were positive for metallo-betalactamases (MBLs) and just the NDM-1 and IMP-1 enzymes were detected in 15,85% and 2,06% on these isolates, respectively. The blaOXA-23 (90%) and blaOXA-143 (28%) genes were the most prevalent. Regarding the biocides susceptibility assessment, 19,25% (26/135) isolates presented reduced sensitivity to chlorhexidine and 40% (54/135) to benzalkonium chloride. The adeB and adeJ genes were detected in almost all isolates corresponding to 115 (85.19%) and 129 (95.85%), respectively, although this results did not show a positive association with tolerance to the biocides tested, statistically (p<0,05). However, qacE gene showed a significant relationship (p=0, 0006) with the susceptibility reduced to chlorhexidine, being present in 46,15% (12/26) of the isolates less susceptible to this compound. Another significant association was observed between the reductions of susceptibility to benzalkonium chloride and the multirresistance profile of the isolates. This research describes strains of A. baumannii with a resistance profile that greatly compromises the treatment of infections by this microorganism, as well as limits the agents used in the hospital sanitization and disinfection process. There should therefore be permanent surveillance of cross-transmission in hospital settings and seek the use of more effective biocides. Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) A espécie bacteriana Acinetobacter baumannii se destaca não somente como um dos principais patógenos envolvidos em infecções relacionadas a saúde (IRAS) em pacientes hospitalizados, particularmente nas Unidades de Terapia Intensiva (UTIs), mas também pela grande capacidade de aquisição de mecanismos de resistência aos antimicrobianos. Recentemente, a redução da susceptibilidade aos biocidas como antissépticos e desinfetantes vem sendo relatado em muitas espécies, incluindo em A. baumannii. Assim, objetivo dessa pesquisa foi determinar o perfil de susceptibilidade aos antibióticos e aos biocidas clorexidina e cloreto de benzalcônio de cepas de A. baumannii provenientes de amostras clínicas de hospitais gerais da cidade de Natal, Estado do Rio Grande do Norte, Brasil. As amostras foram coletadas entre Março de 2013 a Março de 2014. Foram identificadas através de provas bioquímicas convencionais e confirmadas pela pesquisa do gene blaOXA-51 e pelo sistema MALDI-TOF e, estocadas em freezer a -20°C no Laboratório de Bacteriologia Médica da UFRN. Essa pesquisa foi realizada com 135 cepas de A. baumannii, as quais foram avaliadas quanto à susceptibilidade aos antibióticos comumente utilizados na prática clínica, pelo método de disco difusão (Kirby-Bauer) e quanto a resistência aos carbapenêmicos pelo teste do sinergismo disco duplo contendo EDTA (ácido etilenodiaminotetracético). A susceptibilidade aos biocidas foi avaliada pela determinação da concentração inibitória mínima, utilizando o método de microdiluição em caldo, segundo recomendações do CLSI. Além disso, foi aplicada a técnica da reação em cadeia da polimerase (PCR) para a detecção de genes que codificam as carbapenemases IMP-1, VIM-1, NDM-1, OXA-23, -24, -58, -143 e as bombas de efluxo QacE, AdeB e AdeJ. Foi observado um perfil de multirresistência (MDR) aos antibióticos em 70,37% (95/135) dos isolados e 44,21% (42/95) destes, foram extensivamente resistentes (XDR) ao apresentarem resistência a todos os antibióticos, com exceção à tigeciclina, cuja resistência foi observada em apenas um isolado. A resistência aos carbapenêmicos foi observada em 71,85% (97/135). Setenta e sete isolados foram positivos para a produção de metalobetalactamases (MBLs) no qual apenas as enzimas NDM-1 e IMP-1 foram detectadas em 15,85% e 2,06% desses isolados, respectivamente. Os genes blaOXA-23 e blaOXA-143 foram os mais prevalentes, representando 90% e 28% dos isolados, respectivamente. Quanto a avaliação da susceptibilidade aos biocidas, 19,25% (26/135) dos isolados apresentaram susceptibilidade reduzida a clorexidina e 40% (54/135) ao cloreto de benzalcônio. A presença dos genes para as bombas de efluxo AdeB e AdeJ foram positivas na maioria dos isolados correspondendo a 115 (85,19%) e 129 (95,85%), respectivamente, mas estatisticamente não mostraram associação significativa com a tolerância aos biocidas testados (p<0,05). Enquanto que a presença do gene qacEmostrou relação significativa (p=0,0006) com a susceptibilidade reduzido a clorexidina, estando presente em 46,15% (12/26) dos isolados tolerantes a esse composto. Outra associação significativa foi observada entre a susceptibilidade reduzida ao cloreto de benzalcônio com o perfil de multirresistência dos isolados. As cepas de A. baumannii com um perfil de alta resistência compromete enormemente o tratamento de infecções por esse micro-organismo, assim como limita de forma importante os agentes utilizados no processo de higienização e desinfeção hospitalar. Deve haver, portanto, uma vigilância permanente quanto a transmissão cruzada em ambientes hospitalares e buscar o uso de biocidas mais eficazes. 2019-04-05T20:39:00Z 2019-04-05T20:39:00Z 2019-02-28 masterThesis ÉVORA, Bruna Helena Silva Rendall. Susceptibilidade aos antibióticos e aos biocidas clorexidina e cloreto de benzalcônio em isolados clínicos de Acinetobacter baumannii. 2019. 87f. Dissertação (Mestrado em Ciências Biológicas) - Centro de Biociências, Universidade Federal do Rio Grande do Norte, Natal, 2019. https://repositorio.ufrn.br/jspui/handle/123456789/26853 pt_BR Acesso Aberto application/pdf Brasil UFRN PROGRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS BIOLÓGICAS |