Detection of resistance genes in pyometra isolated bacteria in bitches / Detecção de genes de resistência em bactérias isoladas de piometra em cadelas

Pyometra has several immunological and molecular changes that are responsible for uterine inflammation and the disease may or may not have infections. This study aimed to isolate and identify bacteria in the uterine content of bitches with pyometra, to analyze the susceptibility profile to antibiotics, detect ß-lactamase enzyme production by phenotypic tests, and resistance genes to ß-lactams. Eighteen samples of uterine content were collected by aspiration puncture. The samples were inoculated in bacteriological media and identified by biochemical tests. Subsequently, antibiogram tests, screening for detection of ß-lactamases, and Real-Time PCR for detection of resistance genes was performed. Escherichia coli, Klebsiella spp., Enterobacter aerogenes, Citrobacter spp., Staphylococcus spp., and Streptococcus spp. were identified in the analyzed samples of uterine content. In the antibiogram test, 90.5% of the isolates showed resistance to at least one antibiotic, and of these, 36.8% were considered MDR, with three Staphylococcus spp., three E. coli, and one Klebsiellaspp. Concerning bacterial resistance to the groups of antibiotics tested, 38.1% of the isolates were resistant to at least one type of ß-lactam, 33.3% to tetracycline, 19.0% to aminoglycosides, and 14.3% to fluoroquinolones, macrolides, and trimethoprim-sulfamethoxazole. In the phenotypic test to detect ß-lactamase production, E. coli samples were negative and Klebsiella spp. was positive for the production of AmpC, which presented the blaCMY, blaSPM, and blaSIM genes. Bacteria that are resistant to antibiotics represent a great challenge and laboratory support is therefore essential, without which therapeutic success decreases and death may be inevitable.(AU)

A piometra apresenta diversas alterações imunológicas e moleculares que são responsáveis pela inflamação uterina, e a doença pode ser infecciosa ou não. O objetivo deste estudo foi isolar e identificar bactérias no conteúdo uterino de cadelas com piometra, analisar o perfil de suscetibilidade aos antibióticos, detectar a produção de enzimas ß-lactamase por testes fenotípicos e genes de resistência aos ß-lactâmicos. Dezoito amostras de conteúdo uterino foram coletadas por punção aspirativa. As amostras foram inoculadas em meio bacteriológico e identificadas por testes bioquímicos. Posteriormente, foram realizados testes de antibiograma, triagem para detecção de ß-lactamases e PCR em tempo real para detecção de genes de resistência. Escherichia coli, Klebsiella spp., Enterobacter aerogenes, Citrobacter spp., Staphylococcus spp. e Streptococcus spp. foram identificados nas amostras de conteúdo uterino analisadas. No teste de antibiograma, 90,5% dos isolados apresentaram resistência a pelo menos um antibiótico, e destes, 36,8% foram considerados MR, sendo três Staphylococcus spp., três E. coli e uma Klebsiella spp. Sobre a resistência bacteriana aos grupos de antibióticos testados, 38,1% dos isolados foram resistentes a pelo menos um tipo de ß-lactâmico, 33,3% à tetraciclina, 19,0% aos aminoglicosídeos e 14,3% às fluorquinolonas, macrolídeos e trimetoprim-sulfametoxazol. No teste fenotípico para detecção da produção de ß-lactamase, as amostras de E. coli foram negativas, e Klebsiella spp. foi positiva para a produção de AmpC, que apresentou os genes blaCMY, blaSPM e blaSIM. As bactérias resistentes aos antibióticos representam um grande desafio e, portanto, o suporte laboratorial é essencial, sem o qual o sucesso terapêutico diminui e a morte pode ser inevitável.(AU)

Pediatric tracheostomy: epidemiology and characterization of tracheal secretion - a literature review

SUMMARY INTRODUCTION Despite the benefits, tracheostomized children are susceptible to respiratory infections, since the tube is located in a strategic region where there is colonization by several bacteria and biofilm formation. Biofilm is formed when the bacteria adhere strongly to the surfaces of the tubes, providing protection against various types of aggression, such as antibiotic treatment. OBJECTIVE To carry out a literature review of the last ten years on tracheostomized pediatric patients, in order to characterize the bacteria isolated in children's tracheal secretions, and verify which ones are the most frequent. METHODS Two authors searched the Lilacs, SciELO, Medline Plus, and PubMed databases. The MeSH terms used were: 'tracheostomy' and 'tracheotomy' associated with 'infections', 'children', 'child', and 'bacterial' as qualifiers. RESULTS Of the 512 studies on the subject, 19 were selected for review. The total number of children evaluated in the studies was 4,472, with a mean age of 7.5 years. As for the bacteria found in the secretions of tracheostomized children, 12 species of bacteria were more frequent, P. aeruginosa was the predominant bacterium, followed by S. aureus (63.1%), Klebsiella pneumoniae (57.8%), Streptococcus pneumoniae (47.3%), and Stenotrophomonas maltophilia (47.3%). CONCLUSION One of the main complications treated in tracheostomized patients were infections, since the respiratory system is colonized by several bacteria that can cause serious infections, which are associated with the formation of biofilms. The predominant bacterium in most of the studies was P. aeruginosa, and the second species commonly reported was S. aureus.

RESUMO INTRODUÇÃO Apesar dos benefícios, crianças traqueostomizadas estão suscetíveis a adquirir infecções respiratórias, pois o tubo se encontra em uma região estratégica, na qual existe colonização de diversas bactérias e formação de biofilme. O biofilme é formado quando as bactérias aderem fortemente às superfícies dos tubos, conferindo proteção contra diversos tipos de agressões, como o tratamento por antibióticos. OBJETIVO Realizar uma revisão de literatura dos últimos dez anos sobre pacientes pediátricos traqueostomizados, no intuito de caracterizar as bactérias isoladas em secreções traqueais de crianças, verificando-se quais são as mais frequentes. MÉTODOS Dois autores pesquisaram nas bases de dados do Lilacs, SciELO, Medline Plus e PubMed. Termos MeSH utilizados: tracheostomy e tracheotomy usados associados a infections, children, chlid e bacterial como qualificadores. RESULTADOS Dos 512 estudos relacionados ao tema, 19 foram selecionados para a revisão. O total de crianças avaliadas nos estudos foi de 4.472, com idade média de 7,5 anos. Quanto às bactérias encontradas nas secreções de crianças traqueostomizadas, 12 espécies de bactérias foram mais frequentes; P. aeruginosa foi a bactéria predominante, seguida de S. aureus (63,1%), Klebsiella pneumoniae (57,8%), Streptococcus pneumoniae (47,3%) e Stenotrophomonas maltophilia (47,3%). CONCLUSÃO Umas das principais complicações abordadas em pacientes traqueostomizados foram as infecções, já que o sistema respiratório é colonizado por diversas bactérias, que podem causar infecções graves, sendo estas associadas à formação de biofilmes. A bactéria predominante na maioria dos estudos foi a P. aeruginosa, e a segunda espécie comumente relatada foi a S. aureus.

Pediatric tracheostomy: epidemiology and characterization of tracheal secretion - a literature review.

INTRODUCTION: Despite the benefits, tracheostomized children are susceptible to respiratory infections, since the tube is located in a strategic region where there is colonization by several bacteria and biofilm formation. Biofilm is formed when the bacteria adhere strongly to the surfaces of the tubes, providing protection against various types of aggression, such as antibiotic treatment. OBJECTIVE: To carry out a literature review of the last ten years on tracheostomized pediatric patients, in order to characterize the bacteria isolated in children's tracheal secretions, and verify which ones are the most frequent. METHODS: Two authors searched the Lilacs, SciELO, Medline Plus, and PubMed databases. The MeSH terms used were: 'tracheostomy' and 'tracheotomy' associated with 'infections', 'children', 'child', and 'bacterial' as qualifiers. RESULTS: Of the 512 studies on the subject, 19 were selected for review. The total number of children evaluated in the studies was 4,472, with a mean age of 7.5 years. As for the bacteria found in the secretions of tracheostomized children, 12 species of bacteria were more frequent, P. aeruginosa was the predominant bacterium, followed by S. aureus (63.1%), Klebsiella pneumoniae (57.8%), Streptococcus pneumoniae (47.3%), and Stenotrophomonas maltophilia (47.3%). CONCLUSION: One of the main complications treated in tracheostomized patients were infections, since the respiratory system is colonized by several bacteria that can cause serious infections, which are associated with the formation of biofilms. The predominant bacterium in most of the studies was P. aeruginosa, and the second species commonly reported was S. aureus.