| Congresso Brasileiro de Microbiologia 2023 | Resumo: 196-1 | ||||
Resumo:Morganella morganii is a bacterium belonging to the normal intestinal microbiota of mammals, reptiles and the environment. However, in immunocompromised individuals, this bacterium can become an opportunistic pathogen, causing a series of diseases, both in hospitals and in the community, with urinary tract infections (UTIs) being the most prevalent. Therefore, the objective of this study was to evaluate the antimicrobial resistance profile of 138 UTI isolates caused by M. morganii, both in the hospital environment (68) and in the community (70) in the city of Londrina-PR (2016-2020). Based on the analyzes obtained using the Vitek 2 system, the isolates were classified according to their susceptibility to antimicrobials, being tested for the same antimicrobials, from different classes (amikacin (AMI), gentamicin (GEN), aztreonan (AZT); ceftazidime (CAZ); ceftriaxone (CRO); cefepime (CPM); ertapenem (ERT); imipenem (IMP); meropenem (MEM); piperacillin plus tazobactan (PTZ); ciprofloxacin (CIP); norfloxacin (NOR); nalidixic acid (NAL) and sulfazotrim (SUL). Hospital isolates proved to be more resistant to the antimicrobials tested than the community, with 14.70% resistance to AMI; 61.00% resistance to GEN; 79.41% to AZT; 69.11% to CAZ; 64.70% to CRO; 45.58% at CPM; 5.88% to PTZ; 57.35% at CIP; 38.23% to NOR; 35.29% to NAL and 63.23% to SUT. Community isolates show 100% susceptibility to AMI. They showed 28.75% resistance to GEN; 12.5% to AZT and CAZ; 28.75% to CRO; 15% to CPM; 10% to PTZ; 47.14% to CIP; 45.71% to NOR; 75.71% to NAL; and 44.28% to SUT. Regardless of the site or source of infection, the isolates did not show resistance to any carbapenem tested. Although community isolates are more susceptible to antimicrobials, some antibiotics proved to be less effective for community isolates when compared to hospital isolates, as in the case of PTZ (OR: 3.57 IR:1.12.67), CIP and NAL (OR:9.31 IR:3.72,23.31). The diversity of resistance evidenced in our study, reports alarming data when we consider the great intrinsic resistance of M. morganii, which when accompanied by acquired resistance, reduces the availability of treatment, making the patient's recovery difficult. Our study also reveals the presence of multidrug-resistant strains
(MDR) in the hospital and in the community, where hospital isolates are more likely to be MRD (OR:1.74 CI:1.14.2.66) compared to community isolates, showing that the hospital environment is a factor that contributes to the selection of multidrug-resistant strains. The presence of resistance to several antimicrobials in these isolates makes treatment difficult, especially due to the circulation of MDR isolates, both in the hospital and in the community, requiring health surveillance measures and control of their infections, which cannot be neglected. Palavras-chave: resistance, hospital infection, MRD, ITU-CA Agência de fomento:Coordenação de Aperfeiçoamento de Pessoal de Nível Superior- CAPES | |||||