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Previous issue date: 2011-09-30 / Acinetobacter baumannii is an important opportunistic pathogen commonly associated with nosocomial infections, especially in patients hospitalized in intensive care units (ICUs). This microorganism is renowned for its ability to survive under adverse conditions in the environment for extended periods, as well as to rapidly acquire resistance to antimicrobial drugs. Nowadays, the increasing antimicrobial resistance of A. baumannii has been a great challenge for the medical community, since there are few effective options for the treatment of infections caused by this organism. The aim of this study was to evaluate the presence of the A. baumannii from an ICU environment and to characterize the antimicrobial drug resistance of the isolates obtained, as well as of the isolates from patients in ICU of the same hospital in which it was collected environmental samples. For this, 886 environmental and gloves samples were collected from an ICU of S?o Lucas Hospital, Porto Alegre, Brazil, and 46 clinical isolates were obtained from the Laboratory of the same hospital. After the identification of the isolates as A. baumannii by PCR using as target 16S rDNA and blaOXA-51 genes, the resistance to 20 antimicrobial drugs and the production of metallo-beta-lactamases were evaluated in isolates presenting carbapenem reduced susceptibility. Also, it was evaluated the presence of integrons and blaOXA-23 and blaIMP genes by PCR. A. baumannii was identified in 9.6% of environmental and glove samples collected. High percentage of multiresistant (MDR) isolates was found, as well as it was detected high rates of reduced susceptibility to carbapenems. All 89 isolates integron positive were MDR. Between isolates with reduced susceptibility to carbapenems, all presented blaOXA-23, and 41.4% non-clinical and 54% clinical carried the blaIMP. High resistance to polymyxin B was detected, mainly in non-clinical isolates. Although high prevalence has been found in clinical and non-clinical isolates, the latter constitute a great concern, because they can indicate the hospital environment as a reservoir of MDR A. baumannii. / Acinetobacter baumannii ? um importante pat?geno oportunista comumente associado a infec??es nosocomiais, especialmente em pacientes hospitalizados em unidades de tratamento intensivo (UTIs). Este organismo ? reconhecido por sua capacidade de sobreviver em condi??es adversas no ambiente por per?odos prolongados, bem como de facilmente adquirir resist?ncia a drogas antimicrobianas. Atualmente, a crescente resist?ncia antimicrobiana de A. baumannii tem constitu?do um grande desafio para a comunidade m?dica, uma vez que existem poucas op??es efetivas para o tratamento de infec??es causadas por este microrganismo. O objetivo deste estudo foi avaliar a presen?a de A. baumannii no ambiente de uma UTI e caracterizar a resist?ncia a drogas antimicrobianas dos isolados obtidos, bem como de isolados de pacientes internados na UTI do mesmo hospital no qual as amostras ambientais foram coletadas. Para tanto, 886 amostras ambientais e de luvas foram coletadas de uma UTI do Hospital S?o Lucas, Porto Alegre, Brasil, e 46 isolados cl?nicos foram obtidos no Laborat?rio do mesmo hospital. Ap?s a identifica??o dos isolados como A. baumannii atrav?s de PCR utilizando como alvos os genes rDNA 16S e blaOXA-51, foram determinadas a resist?ncia a 20 drogas antimicrobianas previstas pelo CLSI e a produ??o de metalo-betalactamases em isolados com suscetibilidade reduzida aos carbapen?micos. Tamb?m foi avaliada a presen?a de integrons e dos genes blaOXA-23 e blaIMP atrav?s de PCR. A. baumannii foi identificado em 9,6% das amostras ambientais e de luvas coletadas. Obteve-se um alto percentual de isolados multirresistentes (MDR), assim como foram detectadas alta taxas de suscetibilidade reduzida aos carbapen?micos. Todos os 89 isolados que apresentaram integrons foram MDR. Dentre os isolados com suscetibilidade reduzida aos carbapen?micos, todos apresentaram o gene blaOXA-23, e 41,4% n?o-cl?nicos e 54% cl?nicos carrearam o gene blaIMP. Alta resist?ncia ? polimixina B foi detectada, principalmente em isolados n?o-cl?nicos. Embora alta preval?ncia de resist?ncia antimicrobiana tenha sido encontrada em isolados cl?nicos e n?o cl?nicos, os ?ltimos constituem grande preocupa??o, pois podem indicar o ambiente hospitalar como um reservat?rio de A. baumannii MDR.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/5426 |
| Date | 30 September 2011 |
| Creators | Raro, Ot?vio Hallal Ferreira |
| Contributors | Oliveira, Silvia Dias de |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Biologia Celular e Molecular, PUCRS, BR, Faculdade de Bioci?ncias |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 8198246930096637360, 600, 600, 36528317262667714 |
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