Banca de DEFESA: ISABELA MARIA FORTALEZA NEVES BOMFIM

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : ISABELA MARIA FORTALEZA NEVES BOMFIM
DATE: 13/07/2020
TIME: 09:00
LOCAL: Video Conferência
TITLE:

CULTURES OF RESISTANCE SURVEILLANCE OF INTERNAL PATIENTS IN INTENSIVE CARE UNITS IN HOSPITALS CONNECTED TO UFRN

KEY WORDS:

Surveillance cultures; Antimicrobial resistance; Health Associated Infections; Intensive Care Units; Carbapenems.

PAGES: 90
BIG AREA: Ciências Biológicas
AREA: Microbiologia
SUBÁREA: Microbiologia Aplicada
SPECIALTY: Microbiologia Médica
SUMMARY:

Epidemiological surveillance cultures are a set of techniques for isolating and identifying microorganisms resistant to antimicrobials in colonized individuals in order to prevent outbreaks and their transmission between individuals. Intensive Care Units are the places with the highest occurrence of outbreaks by multidrug-resistant bacteria due to the selective pressure caused by antibiotic therapy used in the patients of these units, to the health care conducts, such as use and catheters and tubes, and the weakened state of the patients. In this work, we collected samples from inpatients in the reference hospital in infectious diseases ICU, in Natal / RN, in order to discriminate the most frequent bacteria in this unit. Samples were collected from the rectal, axillary and nasal sites. Then, at the Laboratório de MIcobactérias (LABMIC)/UFRN, the specimens were isolated, identified and after the resistance profile was determined, for the strains resistant to carbapenems, conventional PCRs were performed to determine the presence of the NDM, IMP-1, IMP-2, VIM-1, VIM-2, OXA-23, 0XA-48, KPC and MCR-1 genes and their minimum inhibitory concentration (MIC) determined against the antibiotics Imipenem and Polymyxin B. For bacteria resistant to Oxacillin, the MIC determination for Vancomycin was performed by Etest®. From 24 patients collected in the period between August 2018 and March 2019, 62 bacteria with resistance profile were isolated and identified, with 48 (77%) Gram-negative bacilli (GNB) and 14 (23%) Gram-positive cocci (GPC). Among GNBs, 54% were producers of extended-spectrum beta-lactamases. All GPCs (100%) were resistant to Oxacillin. In Etest® for Vancomycin, no GPC was resistant. Nineteen samples (09 Pseudomonas aeruginosa, 06 Acinetobacter spp. And 04 Klebsiella pneumoniae) showed resistance to carbapenems and their MIC for Imipenem showed 94.7% resistance and the MIC of Polymyxin B, 04 P. aeruginosa and 02 Acinetobacter spp., (31.6%) were resistant and 03 P. aeruginosa (15.8%) had intermediate sensitivity. For the carbapenem resistance genes, the blaNDM-1 gene was expressed by 04 (21%) of the samples, 01 K. pneumoniae, 01 Acinetobacter spp. and 02 P. aeruginosa and the blaKPC gene was expressed by (42.1%) samples: 03 K.pneumoniae, 04 P. aeruginosa and 01 Acinetobacter spp. The other genes were not expressed by any of the isolates. The MCR-1 gene, that confers resistant to Polymyxin B, was also not expressed by any of the samples. The strains found in this study are responsible for severe therapeutic failures, increased patient morbidity and mortality and demonstrate the complexity of the bacterial resistance problem. Thus, this work denotes the need for measures to contain the microorganisms that cause the HAIs and aims to contribute to the improvement of surveillance procedures in the ICU, helping to prevent and control the transmission of multi-resistant bacteria and to establish outbreak and infections control actions in these units.

BANKING MEMBERS:
Presidente - 1714290 - RENATO MOTTA NETO
Interna - 1715271 - RENATA ANTONACI GAMA
Externo à Instituição - CAIO AUGUSTO MARTINS AIRES