Enterococcus resistente aos Glicopetideos em humanos, aves e ambiente, Uberlândia, mg

Abstract

The objective of this investigation was to evaluate the presence of vancomycin-resistant Enterococcus (VRE) in clinical specimens of hospitalized and outpatients (Hospital de Clínicas da UFU), chicken carcasses and feces, and in environmental sources (hospital floor, water and sewage) ) in the city of Uberlândia. The materials from chickens and outpatients were grown in enrichment media and selective for VRE and the rest in selective media containing 20 µg / ml of vancomycin. Suspicious colonies were characterized for the Enterococcus genus by Gram stain and tests for: catalase, tolerance to 6.5% NaCI in "Tripticase Soy Broth" (TSB) and "a-Pyroglutamic Acid p-Naphthylamide" (PYR). Identification at the species level was carried out by traditional tests, although the marked presence of Enterococcus faecalis (96.6%) predominated among cultures of clinical specimens, of the 60 isolates from hospitalized patients, only two were Enterococcus faecium (3 %) one with intermediate resistance (08pg / ml) from a colonized patient using a vancomycin and the other from an infected patient.In total, a quarter of the Enterococcus samples showed low level resistance to penicillins (penicillin and / or ampicillin). 21 Enterococcus isolates with levels 60 were identified high resistance to gentamicin and / or streptomycin, with only one Enterococcus faecium showing resistance to gentamicin. Additionally, the presence of VRE was not detected in the sewage and water collected in different parts of the city, including materials collected in the hospital. Among the four isolates of humans characterized as VRE at the time of primary cultivation, only one was characterized as the Van B phenotype. Although this is a comprehensive study and the existing epidemiological conditions are favorable to the emergence of these microorganisms, the presence of Enterococcus resistant to high concentrations of vancomycin. However, the finding of samples with intermediate resistance in hospitalized patients, where the selective pressing force of glycopeptides is more evident, should serve as an alert / signal regarding presence of VRE in the near future.