Banca de DEFESA: GIULYANA EVELYN OLIVEIRA DA SILVA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
DISCENTE : GIULYANA EVELYN OLIVEIRA DA SILVA
DATA : 28/07/2020
HORA: 09:00
LOCAL: Defesa remota
TÍTULO:

PHENOTYPE AND GENOTYPIC CHARACTERIZATION OF ENTEROBACTERIA PRODUCERS FROM NOVA DELHI METALO-BETA-LACTAMASE (NDM) IN SALVADOR, BA

PALAVRAS-CHAVES:

New Delhi Metalo-beta-lactamase. Enterobacteria. Multidrug resistance.

PÁGINAS: 91
GRANDE ÁREA: Ciências da Saúde
ÁREA: Farmácia
RESUMO:

Introduction: The spread of bacteria resistant to antimicrobials is a threat to public health. In this context, the production of the New Delhi Metalo-beta-lactamase (NDM)  enzyme is a major concern related to its ability to hydrolyze carbapenems, a specific class in the treatment of infections caused by micro-organisms resistant to multiple drugs (MDR). Since the first detection of NDM in 2009 in India, the number of patients colonized or infected with NDM-producing enterobacteria has increased worldwide. Objectives: Determine the prevalence and characterize the molecular profile of NDM-producing enterobacteria in Salvador, Bahia. Methodology: A cross-sectional study was carried out from January 2016 to December 2018 in three tertiary hospitals in Salvador. Bacterial identification and antimicrobial susceptibility tests were performed using the Vitek 2 system (BioMèrieux, France), in addition, phenotypic experimental tests were made for checking colistin resistance (drop test) and evaluation of carbapenema production (mCIM/eCIM). The presence of resistance genes was investigated by PCR, the genetic variability was verified by the total sequencing of the NDM gene. A clonal relationship between those selected was determined by PFGE and MLST. Results: In the three years of research were identified 33 cases of NDM-producing enterobacteria in a total of 301, revealing a prevalence of 11%. Cases occur more frequently in males (63.3%) and among those over 60 years of age (60%). Most isolates were obtained from blood culture (54.6%), followed by rectal swab (15.3%) and uroculture (12.2%). A more frequent species in this study was K. pneumoniae (97%), as they showed 100% resistance to ciprofloxacin, and resistance rates against beta-lactamase inhibitors (96.5%), cephalosporins (96.5%) and carbapenems (96.5%), while the lowest resistance index was against tigecycline (15.4%). The genes encoding ESBL OXA (27%), TEM (22%) and SHV (20.6%) were detected. The co-expression pattern TEM, SHV, OXA-1, CTX-M15, NDM was frequent among those indicated (27.2%). PFGE analysis showed a genetic relationship between the strains, confirmed by the MLST, which identified few ST variants. Conclusion: Here we demonstrated that NDM-producing enterobacteria are associated with an MDR profile, they exhibit rapid dissemination and the potential to cause outbreaks, representing a public health problem whose management constitutes a challenge for the infection control committee.

MEMBROS DA BANCA:
Presidente - 1187203 - JOICE NEVES REIS PEDREIRA
Interno - 287717 - TANIA FRAGA BARROS
Externo à Instituição - DAIANA DE LIMA MORALES