Caracterização de beta-lactamases de espectro ampliado (ESBLs), genes de resistência aos antimicrobianos e conteúdo plasmidial em cepas de Escherichia coli e Salmonella spp. não tifóides isoladas do ambiente hospitalar e da comunidade

• Ano de defesa: 2012
• Autor(a) principal: Queiroz, Mara Lucia Penna
• Orientador(a): Merquior, Vania Lucia Carreira
• Banca de defesa: Andrade, Joao Ramos Costa , Leite, Paola Cardarelli , Marques, Elizabeth de Andrade , Fracalanzza, Sérgio Eduardo Longo
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade do Estado do Rio de Janeiro
• Programa de Pós-Graduação: Programa de Pós-Graduação em Microbiologia
• Departamento: Centro Biomédico::Faculdade de Ciências Médicas
• País: BR
• Palavras-chave em Português: Escherichia coli. Salmonella spp; ESBLs; CTX-M-59; CTX-M-2; CTX-M-9; SHV-5; IncA/C; IncL/M; Escherichia coli; Salmonella; Beta-Lactamases; Infecção hospitalar; Ambiente de instituição de saúde
• Palavras-chave em Inglês: Escherichia coli; Salmonella spp; ESBLs; CTX-M-59; CTX-M-2; CTX-M-9; SHV-5; IncA/C; IncL/M
• Área do conhecimento CNPq: CNPQ::CIENCIAS BIOLOGICAS::MICROBIOLOGIA::MICROBIOLOGIA APLICADA::MICROBIOLOGIA MEDICA
• Link de acesso: http://www.bdtd.uerj.br/handle/1/14362

ESBL-producing Enterobacteriaceae have been described in hospitals and in the community worldwide. In Brazil, ESBL-producing Enterobacteriaceae have also emerged as an important cause of infections, being CTX-M enzymes the most prevalent ESBLs. The objective of this study was to analyze different genotypic aspects related to expression of antimicrobial resistance in isolates of Escherichia coli and Salmonella spp., such as: diversity of ESBLs, antibiotic resistance genes and plasmid content. Epidemiological features of ESBL-producing isolates were also investigated. We studied 88 isolates of enterobacteria, 43 E. coli and 45 Salmonella serotypes of hospital and community (mainly food) origin, isolated in the city of Rio de Janeiro. ESBL expression was observed in seven E. coli isolates (7/43; 16,3%) and in one Salmonella Typhimurium (1/45; 2,3%) and the enzymes identified as CTX-M variants and SHV-5, respectively. Among the E. coli isolates, CTX-M-2 was the most frequent (n=4), being detected in isolates recovered from rectal swabs of hospitalized patients, whereas CTX-M-59 (a CTX-M-2-variant) (n=1) and CTX-M-9 (n=2) were identified in E. coli isolated from clinical specimens. SHV-5-producing S. Typhimurium was isolated from the hospital environment (infant formula). CTX-M-producing E. coli belonged to different phylogenetic groups (A, B1, D) and STs (ST34, ST69, ST101), being blaCTX-M genes were identified in IncA/C plasmids of approximately 150 kb (blaCTX-M-2, blaCTX-M-9, blaCTX-M-59) or 80 kb (blaCTX-M-2). SHV-5-producing S. Typhimurium belonged to a single clone (A-ST19) and blaSHV-5 gene was identified in IncL/M plasmids of approximately 55Kb. This study first described in Brazil the isolation of S. Typhimurium belonging to ST313 commonly associated with severe invasive diseases, particularly in Africa. Genes encoding resistance to non-beta-lactams and class 1 integrons were found among ESBL-producers and non-ESBL-producing multidrug-resistant E. coli and Salmonella spp. In conclusion: i) our results related to E. coli confirmed the dissemination of CTX-M-enzymes (especially CTX-M-2-variants) since, at least, the beginning of the last decade in Rio de Janeiro clinical settings; demonstrated the implication of IncA/C plasmids in the spread of blaCTX-M genes; indicated the possible intra-plasmid evolution of blaCTX-M-59 from blaCTX-M-2; observation of the diversity and multiplicity of plasmids would provide genetic platforms for spread of different antibiotic resistance genes and/or elements; ii) in relation to Salmonella spp. this study described for the first time, the isolation, from infant formula, ESBL- producing S. Typhimurium; has been demonstrated the association of blaSHV-5 to plasmids belonging to IncL/M group, that can be considered epidemic plasmids ; was identified D-ST313 clone in S. Typhimurium, commonly associated with severe invasive diseases, particularly in Africa, among isolates recovered exclusively from hospital.