CARACTERIZAÇÃO DE ENTEROBACTÉRIAS MULTIDROGA RESISTENTE ISOLADAS DE EFLUENTE HOSPITALAR E NÃO HOSPITALAR, EM CAMPO GRANDE – MS

Abstract

The One Health concept recognizes that people's health is clearly linked to the health of animals and the environment and the importance of this relationship in the transmission, persistence and dissemination of antibiotic-resistant bacteria. The spread of antibiotic-resistant bacteria worries the scientific community due to limited therapeutic options and has the consequences, increased morbidity and mortality and increased costs. Still little studied, hospital effluents can be vehicles for the dissemination of numerous pathogenic microorganisms. In this study, the presence of Carbapenemase-producing Enterobacteriaceae in hospital and non-hospital effluents in Campo Grande - MS, from September 2021 to February 2022 was investigated. From the hospital, samples of effluents from the Coronary Unit were collected; Medical, pediatric and Intensive Care Unit wards; Emergency Medical Care; Clinical Surgery; Material Sterilization Center; Gynecology and obstetrics ward and Hospital output. From non-hospital environments, they were collected from Dentistry; Clinical Laboratory; Anhanduí stream; city center; Moreninha neighborhood; an industry and university rectory. For the isolation of bacteria, 1 µL of effluent samples were seeded in selective culture media. Carbapenemase-producing microorganisms were identified and their resistance profile determined by the VITEK-2 automated system. Of 145 Gram-negative bacteria isolated, 32% showed resistance to the carbapenem antibiotics tested. In 16 Enterobacteriaceae with a carbapenemase producer phenotypic profile, the blaKPC gene was identified by PCR. In 100% of the samples tested confirmed the presence of the researched gene, all from the hospital environment. The bacteria identified were: Klebsiella pneumoniae ssp pneumoniae; Enterobacter cloacae complex; Klebsiella pneumoniae ssp ozaenae; Klebsiella oxytoca; Citrobacter farmeri and Kluyvera intermedia. The results show bacteria classified as critical/high priority by the WHO Priority Pathogen List (carbapenem-resistant Enterobacteriaceae) in hospital effluents and are unprecedented in our state. The identification of multidrug-resistant bacteria is of great importance and plays an important role in the transfer of antimicrobial resistance genes between humans, animals and the environment. Fundamental information for establishing control measures that can be adopted by the hospital institution and municipal sanitation service.