MONITORING THE BACTERIAL RESISTANCE PROFILE OF HEALTH CARE-RELATED INFECTIONS (HAI) POST-TRAINING FOR THE PHENOTYPIC DETECTION OF KPC

• DOI: 10.22533/at.ed.1592512201093

• Palavras-chave: Phenylboronic acid, Multi-resistance, Klebsiella pneumoniae, carbapenemase

• Keywords: Phenylboronic acid, Multi-resistance, Klebsiella pneumoniae, carbapenemase

• Abstract:

  INTRODUCTION: the Regional Laboratory Center of the Adolfo Lutz Institute in Ribeirão Preto - VI (CLR-IAL-RP-VI) is a Regional Reference Laboratory for studies and molecular detection of resistance genes in Multi-Drug-resistant Bacteria (BMR). Phenotypic screening with phenylboronic acid (AFB) in multidrug-resistant (MDR) strains increases the percentage of resistance gene confirmation Klebsiella pneumoniae carbapenemase (KPC) by PCR. From April 8 to 12, 2019, theoretical and practical training was offered to microbiologists from local laboratories that serve hospitals, in order to decentralize the screening technique with AFB. OBJECTIVE: to evaluate the efficiency of previous screening with AFB on the resistance profile of Gram negative bacilli of the order Enterobacterales to carbapenem antibiotics, in the city of Ribeirão Preto, from January 2016 to August 2019, considering the training offered at CLR-IAL-RP-VI. METHODOLOGY: in the CLR-IAL-RP-VI MDR strains isolated from clinical samples of hospitalized patients are received. These are phenotypically identified in genus and species and subjected to sensitivity tests by the disk diffusion method according to the “Clinical and Laboratory Standards Institute” and Technical Note 01/2013 of the National Health Surveillance Agency and PCR to detect genes of resistance. RESULTS: from 2016 to March 2019, 22 MDR strains were received. After training, we received 68 MDR strains, previously screened by AFB, being 39 (57%) KPC, two (3%) extended-spectrum beta lactamase (ESBL) by phenotypic detection, 25 (37%) KPC and ESBL and two (3%) strains not carrying resistance genes. CONCLUSION: after training and adherence of some participants, a larger number of strains were received for further molecular studies. Prior screening with AFB in the local laboratory is important to direct the effectiveness of PCR confirmation of resistance genes.

• Número de páginas: 8