Estudo de staphylococcus aureus resistentes à meticilina (MRSA) por técnicas genotípicas e fenotípicas
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Data
2005-12-13
Autores
Braoios, Alexandre [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Staphylococcus aureus é um dos principais agentes de infecção humana, especialmente em indivíduos hospitalizados. Cepas MRSA (Methicillin Resistant Staphylococcus aureus) constituem um grave problema em hospitais de todo o mundo, aumentando a morbidade e mortalidade de indivíduos infectados. A vancomicina é uma das únicas opções terapêuticas. No entanto, o uso excessivo desse antibiótico pode selecionar cepas resistentes, agravando ainda mais o problema. Trabalhadores hospitalares podem carrear S. aureus nas narinas anteriores e pele e, assim, constituem um importante elo na epidemiologia das infecções nosocomiais. Nesse trabalho foram coletadas amostras das mãos e narinas de 100 trabalhadores do Hospital Universitário Dr. Domingos Leonardo Cerávolo da Universidade do Oeste Paulista - UNOESTE, em Presidente Prudente (SP). Desse total, 68% não eram portadores de S. aureus, 27% carreavam S. aureus sensível a meticilina, 4% carreavam MRSA e 1% carreava BORSA (Borderline Oxacillin Resistant Staphylococcus aureus). No mesmo período (julho a dezembro de 2002), 54,3% das infecções estafilocócicas em pacientes internados nessa Instituição tinham como agente MRSA. A técnica da PCR (Polymerase Chain Reaction) Multiplex para a detecção do gene femA (gene espécie-específico), mecA (resistência à meticilina) e ileS-2 (resistência à mupirocina) foi comparada com o método da difusão com discos e provas convencionais de identificação. Os resultados da PCR Multiplex apresentaram completa concordância com os resultados obtidos com os testes fenotípicos convencionais. Para verificar a relação genética entre as 30 cepas MRSA, 5 isoladas de trabalhadores e 25 de pacientes, foram realizadas a antibiotipagem e tipagem molecular através da técnica RAPD (Random Amplified Polymorphic DNA). Pela antibiotipagem as cepas MRSA foram... .
Staphylococcus aureus is considered as a major infeccious disease agent in human, especially in hospitalized people. Methicillin-resistant strains (MRSA) constitute a serious problem in hospitals around the world, increasing the morbity and mortality rate of infected people. Usually, vancomycin is the only therapeutic choice for the treatment of MRSA infections. However, excessive use of this antibiotic can select resistant strains, aggravating the problem. Health workers can carry S. aureus in the anterior nares and skin, constituting an important link for the epidemiology of nosocomial infections. In this study, samples of the hands and nares of one hundred workers from the University Hospital Dr. Domingos Leonardo Cerávolo , at Presidente Prudente, SP, Brazil, were assessed. Among the one hundred workers, 68% did not carry S. aureus, methicillin-susceptible S. aureus was found in 27/100 (27%) of those people; MRSA in 4/100 (4%) and BORSA (Borderline Resistant Staphylococcus aureus) was found in 1 (1%) health worker. In the same period (July to December of 2002), 54,3% of the staphylococcal infections in hospitalized patients were caused by MRSA. Multiplex PCR assay for the detection of femA (species-specific gene), mecA (methicillin resistance gene) and ileS-2 (mupirocin resistance gene) was compared to the disk diffusion susceptibility test and conventional identification test methods. The Multiplex PCR technic results were in complete agreement with the results obtained from conventional methods. Genetic relationship among the 30 MRSA strains, five isolated from workers and twenty five from patients, was established by antibiotyping and molecular typing by RAPD. On the basis of the antibiotyping, the 30 strains were grouped into four clusters (A to D), of a which 87% were grouped into antibiotype A. According to the profile of RAPD, eight clusters... (Complete abstract, click electronic address below).
Staphylococcus aureus is considered as a major infeccious disease agent in human, especially in hospitalized people. Methicillin-resistant strains (MRSA) constitute a serious problem in hospitals around the world, increasing the morbity and mortality rate of infected people. Usually, vancomycin is the only therapeutic choice for the treatment of MRSA infections. However, excessive use of this antibiotic can select resistant strains, aggravating the problem. Health workers can carry S. aureus in the anterior nares and skin, constituting an important link for the epidemiology of nosocomial infections. In this study, samples of the hands and nares of one hundred workers from the University Hospital Dr. Domingos Leonardo Cerávolo , at Presidente Prudente, SP, Brazil, were assessed. Among the one hundred workers, 68% did not carry S. aureus, methicillin-susceptible S. aureus was found in 27/100 (27%) of those people; MRSA in 4/100 (4%) and BORSA (Borderline Resistant Staphylococcus aureus) was found in 1 (1%) health worker. In the same period (July to December of 2002), 54,3% of the staphylococcal infections in hospitalized patients were caused by MRSA. Multiplex PCR assay for the detection of femA (species-specific gene), mecA (methicillin resistance gene) and ileS-2 (mupirocin resistance gene) was compared to the disk diffusion susceptibility test and conventional identification test methods. The Multiplex PCR technic results were in complete agreement with the results obtained from conventional methods. Genetic relationship among the 30 MRSA strains, five isolated from workers and twenty five from patients, was established by antibiotyping and molecular typing by RAPD. On the basis of the antibiotyping, the 30 strains were grouped into four clusters (A to D), of a which 87% were grouped into antibiotype A. According to the profile of RAPD, eight clusters... (Complete abstract, click electronic address below).
Descrição
Palavras-chave
Staphylococcus aureus, Tipagem molecular, MRSA, PCR multiplex
Como citar
BRAOIOS, Alexandre. Estudo de staphylococcus aureus resistentes à meticilina (MRSA) por técnicas genotípicas e fenotípicas. 2005. 104 f. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Ciências Farmacêuticas, 2005.