Resistência a antimicrobianos em escherichia coli isoladas de esgotos hospitalares

Abstract

The presence of antimicrobials in effluents has been the subject of research in areas of public and environmental health, mainly due to the potential development of resistant bacteria and their persistence and dissemination on environment. In scientific community, hospital effluents have been drawing attention as an important source of bacterial resistance antimicrobials and their associated genes. In this context, Escherichia coli is one of the main indicators of water quality, evidencing contamination by sanitary sewage. The analysis of antimicrobial resistance in Escherichia coli can represent a significant approximation of the general effects of antimicrobial resistant bacteria in sanitary sewage and its possible environmental spread. This work aimed to isolate Escherichia coli strains from hospital effluents, verifying the level of resistance of the isolates to specific antimicrobials. The results of the physical-chemical analysis of hospital effluents, in general, are within the range found in the literature, but with differences between them. Evidence of contamination by effluents was found in a lake belonging to a hospital unit. In HJSN 1 and HSJN 2, different resistance profiles were obtained at the influent and effluent. Also at HEAC, resistance profiles were different at HEAC 1 and HEAC 2 points, the last one had a greater variability of antimicrobial types. In HUCAM 2, the highest percentages of resistance were linked, in addition to ampicillin, to amikacin and tetracycline. HUCAM LAGOA also showed resistance to ampicillin and sulfamethoxazole – trimethoprim, but also to ciprofloxacin. Escherichia coli strains expressing multidrug resistance equal to 7 were observed in samples from HEAC, HUCAM Lago and at the WWTP effluent of HJSN. These bacteria that have characteristic antimicrobial resistance profiles may present an environmental risk as these strains of coliform bacteria can spread resistance to other bacteria, including those with pathogenic characteristics. This monitoring of antimicrobials resistance levels in bacteria such as Escherichia coli in effluents can be used as an early warning system for changes in resistance patterns in the human and animal population. However, the potential human and nature risk in relation to the release of hospital effluents from antimicrobial resistant bacteria are still uncertain. It is necessary to standardize reporting and monitoring requirements like so many other water quality parameters, especially in Brazil, to allow the construction of a database that is essential for evidence-based health decision-making