Bezerra Neto Armando Monteiro, Rabelo Marcelle Aquino, Lima Jailton Lobo da Costa, Loibman Stéfany Ojaimi, Leal Nilma Cintra, Maciel Maria Amélia Vieira
Programa de Pós-Graduação em Medicina Tropical, Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Recife, PE, Brasil.
Centro de Biociências, Universidade Federal de Pernambuco, Recife, PE, Brasil.
Rev Soc Bras Med Trop. 2018 May-Jun;51(3):304-309. doi: 10.1590/0037-8682-0159-2017.
The increasing reports of vancomycin-resistant Staphylococcus strains (VRS) haves caused concern worldwide, from the laboratory detection to patient management. This study aimed to identify the occurrence of VRS strains among healthcare professionals from a university hospital.
A total of 102 Staphylococcus sp. isolates from healthcare professionals, obtained in a previous study were evaluated according to standard techniques for VRS detection.
After screening inoculation of plates containing 6µg/ml of vancomycin, 19 resistant isolates were identified. The susceptibility profile to other antimicrobials revealed 18 multidrug resistant isolates. The minimum inhibitory concentration (MIC) was determined by E-test and broth microdilution. According to E-tests, of 19 isolates grown in BHI-V6, four isolates presented MIC ≥ 128 µg/ml, seven with MIC ranging from 4 to 8 µg/ml, and eight with MIC ≤ 2µg/ml. By broth microdilution, 14 isolates presented MIC ≤ 2 µg/ml and five with MIC ≥ 16µg/ml. The presence of the gene vanA was determined by PCR in the five resistant isolates, and this gene was detected in one of the strains. Furthermore, among the 19 strains, the gene mecA was found in 13 (39,4%) isolates, including the strain carrying the gene vanA.
Based on these results, we highlight the presence of one strain carrying both vanA and the mecA genes, as well as multidrug-resistant strains colonizing healthcare professionals, and their importance as potential vectors to spread strains carrying resistance genes in the hospital environment.
从实验室检测到患者管理,耐万古霉素葡萄球菌菌株(VRS)报告的不断增加已引起全球关注。本研究旨在确定一所大学医院医护人员中VRS菌株的出现情况。
根据VRS检测的标准技术,对先前研究中从医护人员处获得的总共102株葡萄球菌分离株进行评估。
在接种含6μg/ml万古霉素的平板进行筛选后,鉴定出19株耐药分离株。对其他抗菌药物的敏感性分析显示有18株多重耐药分离株。通过E试验和肉汤微量稀释法测定最低抑菌浓度(MIC)。根据E试验,在脑心浸液-万古霉素6(BHI-V6)中生长的19株分离株中,4株分离株的MIC≥128μg/ml,7株的MIC范围为4至8μg/ml,8株的MIC≤2μg/ml。通过肉汤微量稀释法,14株分离株的MIC≤2μg/ml,5株的MIC≥16μg/ml。通过PCR在5株耐药分离株中检测vanA基因,该基因在其中一株菌株中被检测到。此外,在19株菌株中,13株(39.4%)分离株中发现了mecA基因,包括携带vanA基因的菌株。
基于这些结果,我们强调存在一株同时携带vanA和mecA基因的菌株,以及定植在医护人员中的多重耐药菌株,及其作为医院环境中携带耐药基因菌株传播潜在载体的重要性。