Caracterização fenotípica e molecular de amostras de Enterococcus isoladas em um hospital universitário da cidade do Rio de Janeiro

Os enterococos estao amplamente distribuidos no ambiente. Nos seres humanos, compoem a microbiota do trato gastrintestinal, da cavidade oral e do trato geniturinario. Nas ultimas decadas, esses microrganismos se tornaram importantes agentes etiologicos de infeccoes hospitalares. Uma caracteristica marcante desses microrganismos e a resistencia intrinseca a varios antimicrobianos utilizados habitualmente no tratamento de infeccoes, alem de alguns fatores que tem sido relacionado a virulencia de enterococos. Este estudo investigou a presenca de enterococos em amostras de infeccao e colonizacao de pacientes hospitalizados, profissionais de saude, dietas hospitalares e manipuladores de alimentos. Foram analisadas 276 amostras de colonizacao, de quadros de infeccao, dietas orais e manipuladores de alimento. Nao foram recuperadas amostras dos profissionais de saude. Todas as amostras foram submetidas a testes convencionais de caracterizacao do genero e especies. Testes de susceptibilidade aos antimicrobianos foram empregados pelo metodo de disco difusao, alem da CIM para vancomicina e teicoplanina. A producao de biofilme e a expressao da gelatinase tambem foram avaliadas. Os genes de resistencia a gentamicina, estreptomicina e vancomicina e os genes de virulencia cylA, esp e fsr foram pesquisados pela tecnica de PCR. O polimorfismo genetico foi determinado por PFGE. A especie E. faecalis foi a prevalente nas amostras isoladas de colonizacao e infeccao (42,2% e 81,9%, respectivamente). E. casseliflavus (58,9%) foi a mais frequente dentre as amostras das dietas hospitalares e E. faecium (46,7%) de manipuladores. Dentre as amostras de colonizacao as maiores taxas de resistencia foram observadas para eritromicina (76,3%) e ciprofloxacina (53,9%). Dentre as amostras de infeccao, >70% foram resistentes a eritromicina, ciprofloxacina e tetraciclinas...(AU) Enterococci are widespread in the nature. In humans, as in the other animals, gastrointestinal tract, the oral cavity and the genitourinary tract. In recent decades, these microorganisms have emerged as one important of the most pathogen associated with nosocomial infections. They shows intrinsic resistance to several antimicrobial commonly used for treatment of the infections. Several potential virulence factors have been identified in enterococci, but none has been established as having a major contribution to virulence in humans, as well as some factors that has been linked to the virulence of enterococci. We analyzed 276 isolates obtained from colonization, infection, hospital diets and food handlers. The isolates were identified by conventional physiological tests for characterization at genus and species level. Antimicrobial susceptibilities were determined by the disk diffusion test method. CIM to vancomycin and teicoplanin were avayable by E-test. The biofilm production and the expression of gelatinase were also evaluated. The genes for resistance to gentamicin, vancomycin, streptomycin resistance genes as code as determinants virulence cylA, esp and fsr were investigated by PCR. The genetic polymorphism was determined by PFGE. E. faecalis was prevalent species recovered from colonization and infection (42.2% and 81.9%, respectively). E. casseliflavus (58.9%) was frequent species among the hospital diets samples. On the other hand, E. faecium (46.7%) was prevalent in food handlers. Among the colonization isolates the highest rates of resistance were observed to erythromycin (76.3%) and ciprofloxacin (53.9%). Although, >70% of infection isolates were resistant to erythromycin, tetracycline and ciprofloxacin...(AU)