Perfil de resistência aos antimicrobianos de cocos gram-positivos e bacilos gram-negativos isolados do ambiente e sítio cirúrgico superficial de cães
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Data
2020-02-28
Autores
Menezes, Mareliza Possa de [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
As infecções causadas por organismos resistentes a múltiplos fármacos (multi-drug resistance – MDR) estão associadas à maior morbidade, mortalidade e aumento significativos nos custos com cuidados da saúde. Cocos Gram-positivos e bastonetes Gram-negativos são os grupos de bactérias mais frequentemente relacionadas a infecção do sítio cirúrgico em cães. Dentro do contexto de saúde única, é imperativo o aprimoramento contínuo de métodos de avaliação de contaminação e infecção bacteriana no ambiente hospitalar veterinário. O presente estudo objetivou avaliar o perfil de resistência de cocos Gram-positivos e bastonetes Gram-negativos isolados nas mãos do cirurgião, antes e após a desinquinação, no ambiente e sítio cirúrgico, durante o transoperatório de cirurgias limpas/limpas-contaminadas (G1;n=20) e cirurgias contaminadas (G2;n=10). Das 150 amostras coletadas, as do ambiente (n=30) foram obtidas pela exposição de placa com ágar Brain Heart Infusion na sala cirúrgica durante o procedimento, enquanto as do sítio cirúrgico (n=60) e as das mãos do cirurgião (n=60) foram coletadas por cotonete estéril e semeadas em ágar sangue e MacConkey. Todas as placas foram incubadas a 37ºC por 24h em estufa bacteriológica sob condições anaeróbias. Colônias sugestivas de cocos Grampositivos e bastonetes Gram-negativos foram submetidas a testes bioquímicos para identificação dos gêneros. Por fim, foi realizado o teste de susceptibilidade aos antimicrobianos por disco difusão em ágar Müller-Hinton. Foram obtidos 43 isolados com características morfológicas e bioquímicas de Staphylococcus spp. e 13 de bastonetes Gram-negativos. No G1 foram isoladas cepas de Staphylococcus spp. coagulase negativa (SCoN) (18/21), Staphylococcus spp. coagulase positiva (SCoP) (2/21) e Pseudomonas spp. (1/21), e no G2 foram isolados SCoN (14/35), SCoP (7/35), Proteus spp. (6/35), E. coli (3/35), Pseudomonas spp. (1/35) e Salmonella spp. (1/35). A proporção de resistência a antimicrobianos das bactérias isoladas variou de 27 a 100%, e a prevalência de MDR foi de 88% em SCoN, 100% em SCoP e 77% em bastonetes Gram-negativos. Dois pacientes do G2 apresentaram infecção do sítio cirúrgico superficial pós-operatório, sendo isoladas cepas de SCoP resistente à meticilina, quinolonas e MDR, Proteus spp. resistente à enrofloxacina e MDR, e Pseudomonas spp. resistente à enrofloxacina. O alto índice de resistência de bactérias comensais encontradas na pele de cães no nosso estudo é alarmante. SCoN são patógenos comunitários relacionadas a infecções hospitalares em hospitais humanos e veterinários, sua presença em pacientes hígidos e em profissionais veterinários representam importante fonte de infecção no contexto de saúde única. Vigilância contínua e aplicação de programas de gestão de antimicrobianos são essenciais na luta contra essa ameaça.
Infections caused by multidrug-resistant (MDR) organisms are associated with increased morbidity, mortality and health care spending. Gram-positive cocci and Gram-negative bacilli are bacterial species frenquently related with surgical site infections in dogs. In the context of one health, become necessary the continuous improvement of evaluation methods of bacterial infection and contamination in the veterinary hospital environment. The present project aims to evaluate the antimicrobial profile of Gram-positive cocci and Gram-negative bacilli isolated of the surgical site and room during the intraoperative period and of the surgeon’s hands, before and after antisepsis. All samples were obtained during intraoperative of clean/cleancontaminated (G1) and contaminated surgery (G2). A total of 153 samples were collected, of which the environmental samples were obtained by exposure of Brain Heart Infusion agar plate in the surgical room during the procedure and samples from the surgical site and surgeon’s hands were collected by swabs and seeded on blood and Macconkey agar. The plates were incubated at 37ºC for 24h. Suggestive bacterial colonies for Gram-positive cocci and Gram-negative bacilli were submitted to biochemical test for genus differentiation. Finally, antimicrobial susceptibility testing was performed by disk diffusion method. Forty-three isolates with morphological and biochemical characteristics of Staphylococcus spp. and 13 of Gram-negative bacilli were obtained. Were isolated coagulase-negative staphylococci (CoNS) (18/21), coagulase-positive staphylococci (CoPS) (2/21) and Pseudomonas spp. (1/21) in G1, and CoNS (14/35), CoPS (7/35), Proteus spp. (6/35), E. coli (3/35), Pseudomonas spp. (1/35) and Salmonella spp. (1/35) in G2. Multiple drug resistance rate was 88% in CoNS, 100% in CoPS and 77% in Gram-negative bacilli. The high rate of resistance of commensal bacteria found on the skin of dogs in our study is worrying. SCoN are community pathogens related to nosocomial infections in human and veterinary hospitals, their presence in healthy patients and in veterinary professionals represent an important source of infection in the one health context. Continuous surveillance and application of antimicrobial stewardship programs are essential in the fight against this threat.
Infections caused by multidrug-resistant (MDR) organisms are associated with increased morbidity, mortality and health care spending. Gram-positive cocci and Gram-negative bacilli are bacterial species frenquently related with surgical site infections in dogs. In the context of one health, become necessary the continuous improvement of evaluation methods of bacterial infection and contamination in the veterinary hospital environment. The present project aims to evaluate the antimicrobial profile of Gram-positive cocci and Gram-negative bacilli isolated of the surgical site and room during the intraoperative period and of the surgeon’s hands, before and after antisepsis. All samples were obtained during intraoperative of clean/cleancontaminated (G1) and contaminated surgery (G2). A total of 153 samples were collected, of which the environmental samples were obtained by exposure of Brain Heart Infusion agar plate in the surgical room during the procedure and samples from the surgical site and surgeon’s hands were collected by swabs and seeded on blood and Macconkey agar. The plates were incubated at 37ºC for 24h. Suggestive bacterial colonies for Gram-positive cocci and Gram-negative bacilli were submitted to biochemical test for genus differentiation. Finally, antimicrobial susceptibility testing was performed by disk diffusion method. Forty-three isolates with morphological and biochemical characteristics of Staphylococcus spp. and 13 of Gram-negative bacilli were obtained. Were isolated coagulase-negative staphylococci (CoNS) (18/21), coagulase-positive staphylococci (CoPS) (2/21) and Pseudomonas spp. (1/21) in G1, and CoNS (14/35), CoPS (7/35), Proteus spp. (6/35), E. coli (3/35), Pseudomonas spp. (1/35) and Salmonella spp. (1/35) in G2. Multiple drug resistance rate was 88% in CoNS, 100% in CoPS and 77% in Gram-negative bacilli. The high rate of resistance of commensal bacteria found on the skin of dogs in our study is worrying. SCoN are community pathogens related to nosocomial infections in human and veterinary hospitals, their presence in healthy patients and in veterinary professionals represent an important source of infection in the one health context. Continuous surveillance and application of antimicrobial stewardship programs are essential in the fight against this threat.
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Palavras-chave
Teste de susceptibilidade antimicrobiana, Antibiótico, Cultivo microbiológico, Enterobactérias, Infecção do sítio cirúrgico, Staphylococcus