Antimicrobial Susceptibility and Molecular Epidemiology of Multidrug-resistant Pseudomonas aeruginosa in Northeast of Brazil

Stephanie de Almeida-Alves, Ludimila Gomes Pinheiro, Izabelly Linhares Ponte-Brito, Paulo de Tarso Teles Dourado de Aragão, Guilherme Mendes Prado, Júlio César Sousa Prado, R. Fontenelle, Francisco Cesar Barroso Barbosa
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Abstract

Introduction: This study aimed to investigate the antimicrobial susceptibility profile of nosocomial strains of Pseudomonas aeruginosa isolated from inpatients of a teaching hospital in the City of Sobral, Ceará, in Northeast of Brazil (Santa Casa de Misericórdia de Sobral - SCMS) from March/2019 to March/2020, as well as to assess the occurrence of resistance genes bla-TEM, bla-SHV, bla-CTX-M 1/2, bla-IMP-1, bla-KPC, bla-GES, bla-SPM-1, bla- NDM-1, bla-VIM. Methodology: Bacterial identification and antimicrobial susceptibility tests (AST) were performed using the automated system Vitek®2. Conventional polymerase chain reaction (PCR) was used to amplify genes of interest. Results: Thirty-eight specimens of P. aeruginosa were collected. More than half of the isolates were resistant to imipenem (55.2%), and showed different rates of resistance to the other antimicrobials tested. In addition, intermediate susceptibility was also observed to gentamicin (7.8% of the isolates) and meropenem (10.52% of the isolates). The gene bla-CTX-M 1/2 was the most prevalent (41.9%), while bla-GES was highly identified among the carbapenemase-producing strains (12.9%). Conclusion: The results demonstrated considerable resistance rates to β-lactam antibiotics, which could be attributable to the indiscriminate use of these antibiotics in the analyzed hospital, whose control relies on the improvement of antimicrobial prescription policies.
巴西东北部耐多药铜绿假单胞菌的抗菌药敏感性和分子流行病学研究
导言:本研究旨在调查巴西东北部塞阿拉州索布拉尔市一所教学医院(Santa Casa de Misericórdia de Sobral - SCMS)住院病人中分离出的铜绿假单胞菌鼻腔菌株的抗菌药敏感性谱、并评估耐药基因 bla-TEM、bla-SHV、bla-CTX-M 1/2、bla-IMP-1、bla-KPC、bla-GES、bla-SPM-1、bla-NDM-1、bla-VIM 的发生情况。方法:使用 Vitek®2 自动系统进行细菌鉴定和抗菌药物敏感性试验(AST)。采用常规聚合酶链反应(PCR)扩增相关基因。结果:收集到 38 份铜绿假单胞菌标本。半数以上的分离菌株对亚胺培南(55.2%)具有耐药性,对其他抗菌药的耐药率也不尽相同。此外,还观察到对庆大霉素(7.8% 的分离株)和美罗培南(10.52% 的分离株)的中间敏感性。bla-CTX-M 1/2是最常见的基因(41.9%),而在产生碳青霉烯酶的菌株中,bla-GES的鉴定率很高(12.9%)。结论研究结果表明,β-内酰胺类抗生素的耐药率相当高,这可能与分析医院滥用这些抗生素有关,其控制有赖于抗菌药物处方政策的改进。
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