Banca de QUALIFICAÇÃO: BRUNA HELENA SILVA RENDALL ÉVORA

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
DISCENTE : BRUNA HELENA SILVA RENDALL ÉVORA
DATA : 08/02/2019
HORA: 09:00
LOCAL: Sala de Reuniões do CB
TÍTULO:

SUSCEPTIBILITY TO ANTIBIOTICS AND BIOCIDES CHLOREXIDINE AND BENZALCONIUM CHLORIDE IN CLINICAL ISOLATES OF Acinetobacter baumannii

PALAVRAS-CHAVES:

Acinetobacter baumannii, Resistant, Biocides, Chlorexidine, Benzalkonium Chloride

PÁGINAS: 97
GRANDE ÁREA: Ciências Biológicas
ÁREA: Microbiologia
SUBÁREA: Biologia e Fisiologia dos Microorganismos
ESPECIALIDADE: Bacterologia
RESUMO:

The bacterial species Actintobacter baumannii stands out not only as one of the main pathogens involved in health-related infections (HRE) in hospitalized patients, particularly in Intensive Care Units (ICUs), but also because of the great capacity of antimicrobial resistance mechanisms. Recently, the reduction of susceptibility to biocides as antiseptics and disinfectants has been reported in many species, including A. baumannii. The objective of this research was to characterize phenotypically and genotypically the susceptibility profile to antibiotics and biocides Chlorhexidine and Benzalkonium Chloride from A.baumannii isolates from clinical samples from patients hospitalized in ICUs from four general hospitals located in Natal-RN. The samples were collected from March 2013 to March 2014, identified by conventional biochemical tests and confirmed by the blaOXA-51e gene by the MALDI-TOF system and stored in a freezer at -20 ° C in the Laboratory of Medical Bacteriology (LaBMed) from UFRN. This research was carried out with 135 strains of A.baumannii, which were evaluated for the susceptibility to antibiotics commonly used in clinical practice, by the disc diffusion method (kirby-bauer) and for resistance to carbapenems by the synergism using disks containing EDTA (Ethylenediaminetetraacetic acid). The susceptibility to the biocides was evaluated by determination of the Minimal Inhibitory Concentration (MIC) using the broth microdilution method, according to CLSI recommendations. In addition, the Chain Reaction technique (PCR) for the detection of genes encoding the carbapenemases IMP-1, VIM-1, NDM-1, OXA-23, -24, -58, -143 and the efflux pumps QacE, AdeB and AdeJ. A multiresistant antibiotic profile (MDR) was observed in 70% (95/135) of the isolates and 32% of these were extensively resistant (XDR) when resistant to all antibiotics, except for tigecycline, whose resistance was observed in only an isolate. Resistance to carbapenems was observed in 71.85% (97/135) of the isolates and 77 (74.75%) of these were positive for the production of metallo-carbapenemases (MBLs). The blaOXA-23e and blaOXA-143 genes were the most prevalent, accounting for 90% and 28% of the isolates, respectively. Of the MBLs studied, only the NDM-1 and IMP-1 enzymes were detected in 13% and 2% of the isolates, respectively. Regarding the biocides susceptibility evaluation, 19.25% (26/135) of the isolates presented reduced susceptibility to chlorhexidine and 40% (54/135) to benzalkonium chloride. The presence of the genes for the AdeB and AdeJ efflux pumps were positive in most isolates, but statistically did not show a positive correlation with tolerance to the biocides tested. While the presence of the qac gene showed a significant relationship with the reduction of susceptibility to chlorhexidine, being present in 46.15% of the isolates not susceptible to this compound. Another significant relationship was also observed between the reduction of susceptibility to benzalkonium chloride and the multiresistance profile of the isolates. The observed resistance raises concern, since the appearance and propagation of strains with this profile can compromise the treatment and strategies of hospital infection control. In addition, the data observed in this study may be indicative of a possible flaw in the hygienization and hospital disinfection process. 

MEMBROS DA BANCA:
Interno - 348473 - JOSE VERISSIMO FERNANDES
Interna - 1452833 - MARIA CELESTE NUNES DE MELO
Externo ao Programa - 348109 - PAULO ROBERTO MEDEIROS DE AZEVEDO