Avaliação do perfil de sensibilidade antimicrobiana e detecção de genes de resistência em bactérias gram-negativas isoladas de pacientes com covid-19 assistidos num hospital terciário da região norte do Ceará

Abstract

Patients with COVID-19 may be at risk of concomitant bacterial infections, including hospital acquired multidrug resistant (MDR) gram-negative bacteria, and prompt administration of antibiotics in accordance with antimicrobial susceptibility reports is essential to reduce severity, complications and morbidity and mortality. The aim of this study was to evaluate the antimicrobial sensitivity profile and detect the presence of resistance genes in gram -negative bacilli (GNB) isolated from patients diagnosed with COVID -19 treated at a tertiary hospital in the Northern Region of Ceará. Microbiological data from patients with bacterial co -infections were collected by the Hospital Infection Control Committee of the aforementioned hospital from April/2021 to March/2022 and a total of 46 GN B were isolated. Bacterial identification and sensitivity profile were performed by the automated system VITEK®2 (bioMérieux) and molecular analysis to detect the genes bla KPC, bla NDM-1, bla OXA-23 and bla OXA-48 was performed by Chain Reaction Polymerase (PCR), followed by electrophoretic run in agarose gel Of the total GNB analyzed, the highest frequency was Klebsiella pneumoniae (n = 18; 39.1%), followed by Acinetobacter baumannii and Pseudomonas aeruginosa with 12 (26.1%) isolates of each. Regarding hospitalization, 58.7% were in the Intensive Care Unit (ICU) sector and half of the isolates were characterized as agents of Healthcare -Associated Infections (HAIs). For antimicrobial sensitivity, the highest resistance rate was found for Imipenem (60.9%), followed by Piperacillin/Tazobactam (54.3%). However, 58.7% of GNB were sensitive to Aztreonam. Among the genes encoding ESBLs, bla KPC was the most frequent, detected in 31 (67.4%) of the isolates prevalent in K. pneumoniae, and bla OXA-23 in specimens of A. baumannii (n = 26; 56 .5%). On the other hand, seven samples showed the coexistence of three genes simultaneously. Therefore, these data could be useful for gen erating important information to control the spread of these pathogens in the hospital environment, directly affecting patient safety and improving the quality of care.