Banca de QUALIFICAÇÃO: EMÍLIA SOUSA DE OLIVEIRA

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
DISCENTE : EMÍLIA SOUSA DE OLIVEIRA
DATA : 08/02/2019
HORA: 13:30
LOCAL: Sala de Reuniões do CB
TÍTULO:

SILENT SPREAD: MOLECULAR CARACTERIZATION OF VANCOMYCIN-RESISTANTENTEROCOCCUS SP.  IN CITY OF NATAL-RN

PALAVRAS-CHAVES:

Vancomycin-resistant Enterococcus, clonal spread, colonization, PFGE, MLST

PÁGINAS: 88
GRANDE ÁREA: Ciências Biológicas
ÁREA: Microbiologia
SUBÁREA: Biologia e Fisiologia dos Microorganismos
ESPECIALIDADE: Bacterologia
RESUMO:

Vancomycin-resistant enterococci (VRE) clonal spread and outbreaks cause major problems in health institutions around the world. In Brazil, several available studies describe VRE outbreaks or clonal dissemination scenarios mostly involving Enterococcus faecalis and Enterococcus faecium. We aimed to characterize, at molecular level, the VRE recovered from patient colonization and infection in different hospitals of Natal. Sixty-two VRE isolates were collected from 51 patients of 7 hospitals (2015-2016). They were from colonization (n=56 from perianal swabs) and infection (n=6; urine, catheter tips, ulcer secretion, ocular secretion and bone fragment) contexts. Identification at the species level was performed by automated system VITEK 2 and confirmed by PCR (sodA and ddl genes). Susceptibility to eleven antibiotics were assessed by disk-difusion, E-test (vancomycin) and agar dilution (teicoplanin) (EUCAST, 2018; CLSI, 2018). Search of vancomycin resistance (vanA/vanB) and putative virulence (cylA/asa1/gelE/esp) genes was performed by PCR. Clonal relationship was evaluated by PFGE, and representative strains from main PFGE types also by MLST.Sixty-one isolates were identified as Enterococcus faecalis and only one as Enterococcus faecium. Resistance to vancomycin (MIC =16 to > 256mg/L; vanA), teicoplanin ciprofloxacin, tetracycline and erythromycin were observed in all isolates, and 98,4% were to teicoplanin (MIC = 4 to 64mg/L). In addition, 88,7% (n=54/62) and 40,3% (n=25/62) were also resistant to gentamicin or streptomycin, respectively. None was resistant to linezolid or clorofenicol. Just the E. faecium was ampicillin resistant. Occurrence of virulence factors included gelE (98,4%; n=60/61), asa1 (100%; n=61/61), cylA (16,4%; n=10/61) and esp (9,8%; n=6/61). Two PFGE types were identified; type A (n=31 isolates; 6 hospitals; 28-colonization/3-infection; ST525) and type B (n=30 isolates; 7 hospitals; 27-colonization/3-infection; ST6). Both clones were co-circulating during the period of the study. This study highlights a high rate of patient colonization with MDR vanA-type E. faecalis and a silent spread of two clones previously associated with human infections in Brazil (ST525) or worldwide (ST6). Although their transmission routes remain to clarify, the inter-hospital spread during a long period of time highlight the need of better hygiene measures and antimicrobial stewardship to contain a potential multi-hospital epidemic scenario associated with infection.

MEMBROS DA BANCA:
Interna - 1452833 - MARIA CELESTE NUNES DE MELO
Interna - 2121234 - VANIA SOUSA ANDRADE
Externa ao Programa - 1415086 - MIRELLA ALVES DA CUNHA