TITLE:
Epidemiological Characteristics, Resistance Patterns and Spread of Gram-Negative Bacteria Related to Colonization of Patients in Intensive Care Units
AUTHORS:
Quésia Souza Damaceno, Jacques Nicoli, Adriana Cristina Oliveira
KEYWORDS:
Intensive Care Unit, Bacterial, Drug-Resistance, Gram-Negative Aerobic Bacteria, Colonization
JOURNAL NAME:
Advances in Infectious Diseases,
Vol.5 No.1,
February
25,
2015
ABSTRACT: Our aim was to determine the
epidemiological characteristics, the resistance patterns
and the spread of Gram negative bacteria related to colonization of patients in adult
Intensive Care Units. Methods: A prospective cohort
of patients colonized and/or infected with Gram negative bacteria was conducted at
two adult ICUs from hospitals in Brazil (April 2012 to February 2013). Nasal,
groin and perineum swabs were performed. Samples were incubated on MacConkey
and cetrimide agar (48 h at 37℃) and identification
tests (Vitek-BioMérieux), antibiogram (Bauer-Kirby method), Carba NP test, Polymerase Chain Reaction
(PCR) and sequencing were performed. The patterns of resistant
microorganisms were compared by rep-PCR (Diversilab). Results: There were 53 cases
of colonization. In these cases, we identified imipenem-resistant Acinetobacter baumannii (51%), Pseudomonas aeruginosa (32%), Klebsiella pneumoniae ESBL (38%) or
imipenem resistant (5.6%). The use of antimicrobials and medical devices
were related to colonization (p The resistance patterns expressed by Klebsiella pneumoniae were ESBL (CTX-M,
SHV e TEM) and KPC2. A verified profile of Acinetobacter baumannii was related to OXA-23 and OXA-253 (OXA-143
variant). The profiles ESBL and KPC2 expressed by Klebsiella pneumoniae were distributed
between the both ICUs. The distribution of OXA-23 and OXA-253 was verified only
in one ICU. The similarity of strains ranged
from 80% to 95%, highlighting the horizontal transference of these microorganisms.