Danielly da Costa Silva

Phenotypic methods for screening carbapenem-resistant Enterobacteriaceae and assessment of their antimicrobial susceptibility profile

INTRODUCTION: In this study, we used phenotypic methods to screen carbapenem-resistant Enterobacteriaceae (CREs) and evaluated their antimicrobial sensitivity profile. METHODS: One hundred and seventy-eight CREs were isolated at a university hospital in south Brazil in a one-year period. Samples were assessed using disk diffusion tests with inhibitors of β-lactamases such as phenylboronic acid (AFB), cloxacillin (CLOXA), and ethylenediaminetetraacetic acid (EDTA). Strains with differences in zone diameters ≥ 5mm for disks supplemented or not were considered producers of carbapenemases. RESULTS: Klebsiella pneumoniae was the most prevalent CRE, which appeared in 80.3% cases (n = 143). Among clinical materials, the rectal swab was responsible for 43.4% of the isolations (n = 62), followed by urine (18.9%; n = 27). Among the CREs identified in this study, the growth of 56.7% (n = 101) isolates, which were putative producers of Klebsiella pneumoniae carbapenemase (KPC), were inhibited by AFB, whereas 7.3% (n = 13) isolates were inhibited by both AFB and CLOXA and were considered as putative producers of plasmid-mediated AmpC; approximately 3.4% (n = 6) were inhibited by EDTA, which possibly produced metallo-β-lactamase. Lastly, 32.6% (n = 58) cases showed negative results for AFB, CLOXA, and EDTA sensitivity, and represented another class of β-lactamases and/or mechanism of resistance. CONCLUSIONS: Phenotypic screening of CREs is important for clinical laboratories that monitor outbreaks of resistant microbes. Phenotypic tests that use carbapenemase inhibitors and enhancers such as AFB, CLOXA, and EDTA are necessary since they are good screening methods for the detection of carbapenemases.

Evaluation of carbapenem-resistant Enterobacteriaceae in a tertiary-level reference hospital in Rio Grande do Sul, Brazil

INTRODUCTION The rapid global spread of carbapenem-resistant Enterobacteriaceae (CRE) is a threat to the health system. METHODS We evaluated the antimicrobial susceptibility profiles of 70 CRE isolated in a tertiary hospital in Brazil between August and December 2015, and determined their resistance mechanisms. RESULTS The most prevalent microorganism was Klebsiella pneumoniae (95.7%); it showed high-level resistance to carbapenems (>98%), with sensitivity to colistin (91.4%) and amikacin (98.6%). The bla KPC gene was detected in 80% of the CRE isolates. CONCLUSIONS Evaluation of bacterial resistance contributes to an appropriate treatment, and the reduction of morbimortality and dissemination of resistance.

ABORDAGEM DAS DOENÇAS SEXUALMENTE TRANSMISSÍVEIS NA ADOLESCÊNCIA: REVISÃO DE LITERATURA

O estudo objetivou reportar sobre os riscos de contagio das Doencas Sexualmente Transmissiveis (DSTs), apresentando as principais formas de transmissao, sinais e sintomas associados, tratamento e prevencao. Realizou-se uma revisao bibliografica no periodo de abril a junho de 2015, por meio das bases de dados (SciELO, PubMed, LILACS e BIREME), cartilhas e materiais do Ministerio da Saude, publicados entre 2003 a 2015 envolvendo os descritores: “doencas sexualmente transmissiveis”, “adolescente”, “sexualidade” e “vulnerabilidade em saude” no idioma ingles e portugues. A busca resultou em 63 publicacoes das quais 58 foram selecionadas a partir da leitura dos resumos dos materiais para elaboracao deste trabalho por abordarem o tema proposto. Pode se observar que a disseminacao das DSTs entre a populacao jovem e crescente, sendo necessario investir continuamente em acoes de carater educativo que visem a reducao dos fatores de riscos e possam contribuir para sua cidadania. Descritores: Doencas Sexualmente Transmissiveis; Adolescente; Sexualidade; Vulnerabilidade em Saude.