| Congresso Brasileiro de Microbiologia 2023 | Resumo: 276-1 | ||||
Resumo:Enterobacterales are common bacteria residing in mucosal surfaces of humans, but most associated with complicated infections. However, they often present resistance to the foremost antimicrobials, leading to hard-to-treat infections. Since foodstuffs are recognized as source of bacteria, we aimed to investigate the presence of β-lactam resistant Enterobacterales in ready-to-eat food served to patients admitted to a tertiary-care hospital in Brazil. Therefore, 92 vegetables (24 cabbages and 14 lettuces) and meat (24 chicken, 20 beef and 10 pork preparations) sample preparations were weekly analyzed directly before distribution to patients over four months in 2022. Samples were enriched in peptone water supplemented with cefotaxime (4 µg/mL), and then inoculated onto MacConkey agar supplemented as well. Colonies with characteristic morphologies of Enterobacterales were purified and identified using 16S rDNA sequencing. Antimicrobial susceptibility was tested using 11 different classes according to BrCAST guidelines, and genes coding for β-lactamases were screened accordingly. Additionally, tolerance to different pH values was attested. Overall, Enterobacterales were detected in 23 (25.0%) foodstuffs (19 vegetable and 4 meat preparations). Eleven isolates were identified as belonging to the Klebsiella oxytoca complex, eight to the Enterobacter cloacae complex, five Klebsiella pneumoniae, and two Escherichia coli. Most isolates (88.5%, 23/26) was considered multidrug-resistant, with 57.7% (15/26) presenting resistance to ertapenem and other β-lactams, but all were susceptible to polymyxin B. Resistance to β-lactams was mainly codified by blaCTX-M-1-like genes (9/26 isolates), but blaSHV-like (4/26), blaKPC-like (3/26), blaCMY-like (3/26), blaCTX-M-2-like (2/26), blaCTX-M-8-like (2/26), blaCTX-M-9-like (2/26), and blaACT-like (1/26) were also found. The blaKPC gene was detected in two E. cloacae and one K. oxytoca complexes isolated from vegetables served to patients, which demonstrates a route for spreading of such harmful gene. Moreover, all but one isolate resisted to pH = 4,0 or higher for up to 24 hours, and some tolerated even pH = 3,0 for up 2 hours, demonstrating the possibility of such isolates for resisting to an important human gastrointestinal protection. In conclusion, hospital foodstuffs represent a risk in acquiring important multidrug-resistant bacteria harboring clinically relevant β-lactamase genes to debilitated patients through consumption. These results suggest that improvement in surveillance to antimicrobial resistant bacteria must be performed considering alternative routes other than patients’ colonization. Palavras-chave: antimicrobial resistance, enterobacteria, food, hospital Agência de fomento:Fundação de Amparo à Pesquisa do Estado de São Paulo – FAPESP (2020/08482-8) | |||||