Perfil de resistência de enterobactérias isoladas em secreção traqueal e hemocultura de pacientes em uma unidade de terapia intensiva

Abstract

Enterobacteria are involved in Health Care Related Infections (HAI) and are isolated in the blood culture and tracheal secretion. There are several resistance mechanisms involved in this family, especially the production of Extended Spectrum Beta-lactamases (ESBL) and Klebsiellapneumoniaecarbapenemase (KPC).OBJECTIVE: To evaluated the presence and resistance profile of enterobacteria derived from tracheal secretion and blood culture from an Intensive Care Unit (ICU). MATERIAL AND METHODS: Mac Conkey Agar, Triple Sugar Iron and Gram were used for bacterial identification. Antimicrobial resistance was identified by the disc diffusion method and the disc approach and modified Hodge tests were performed to verify the production of ESBL and KPC, respectively. RESULTS:9 isolates from tracheal secretion and 8 from blood culture were identified. Proteusmirabilis (41%), Serratiarubidaea (17%), Enterobacteraerogenes (12%), Enterobactersakazaki (6%), Providenciarettgeri (6%), Klebsiellaoxytoca (6%), Klebsiellapneumoniae (6%) and Escherichia coli (6%). The antimicrobial resistance test showed multiresistant isolates. 35.3% were producers of ESBL and 41.1% of KPC. DISCUSSION: Of Gram-negative bacteria, enterobacteria are the most commonly found in ICU isolated,with a high rate of antimicrobial resistance. The production of ESBL and KPC aggravates the infection by these pathogens, as seen in the literature. CONCLUSION: The identification of these multiresistant pathogens their resistance mechanisms is very important for effective treatment and faster recovery for patients.