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.
A serious emerging problem worldwide is increased antimicrobial resistance. Acquisition of coding genes for evasion methods of antimicrobial drug mechanisms characterizes acquired resistance. This phenomenon has been observed in Enterobacteriaceae family. Treatment for bacterial infections is performed with antibiotics, of which the most used are beta-lactams. The aim of this study was to correlate antimicrobial resistance profiles in Enterobacteriaceae by phenotypic methods and molecular identification of 14 beta-lactamase coding genes. In this study, 70 exclusive isolates from Brazil were used, half of which were collected in veterinary clinics or hospitals Phenotypic methodologies were used and real-time PCR was the molecular methodology used, through the Sybr Green system. Regargding the results found in the tests it was observed that 74.28% were resistant to ampicillin, 62.85% were resistant to amoxicillin associated with clavalunate. The mechanism of resistance that presented the highest expression was ESBL (17.14%). The genes studied that were detected in a greater number of species were blaGIM and blaSIM (66.66% of the samples) and the one that was amplified in a smaller number of samples was blaVIM (16.66%). Therefore, high and worrying levels of antimicrobial resistance have been found in enterobacteria, and a way to minimize the accelerated emergence of their resistance includes developing or improving techniques that generate diagnoses with high efficiency and speed.
Background: A serious emerging problem worldwide is increased antimicrobial resistance. Acquisition of coding genes for evasion methods of antimicrobial drug mechanisms characterizes acquired resistance. This phenomenon has been observed in several bacteria, including major species of Gram-negative bacteria such as the Enterobacteriaceae family. Among these, strains resistant to multiple classes of antibiotics were observed. Treatment for bacterial infections is performed with antibiotics and among the most used beta-lactams stand out. Resistance to this class of antimicrobials has also increased. The aim of this study was to correlate antimicrobial resistance profiles in Enterobacteriaceae by phenotypic methods and molecular identification of 14 beta-lactamase coding genes: blaOXA; blaIMP; blaNDM; blaSME; blaDHA; blaCMY, blaTEM, blaKPC, blaSPM, blaCTX-M, blaVIM, blaSIM, blaGIM, and blaSHV. Methods: The phenotypic methodologies used were the Antimicrobial Sensitivity Test for Disk-Diffusion, and complementary tests for the detection of resistance mechanisms of beta-lactamases (ESBL, MBL, AmpC and Carbapenemase). The molecular methodology used was Real Time PCR using the Sybr Green system. Results: Among the results found in the tests it was observed that 74.28% were resistant to ampicillin, 34.28% were resistant to aztreonam, 62.85% were resistant to amoxicillin associated with clavalunate, 51.42% were resistant to ceftazidime, 41.42% were resistant to cefoxitin, 54.28% were resistant to cefazolin, 44.28% were resistant to cefepime, 41.42% were resistant to cefuroxime, 8.57% were resistant to cefuroxime, 35.71% were resistant an imipenem and 41.42% were resistant to piperacillin associated with tazobactam. Among the total samples, the mechanism of resistance that presented the highest expression was ESBL (17.14%). The genes studied that were detected in a greater number of species were blaGIM and blaSIM (66.66% of the samples). The gene that was amplified in a smaller number of samples was blaVIM (16.66%). Conclusions: It is concluded that although there is a low correlation between the methodologies analyzed, the levels of antimicrobial resistance in enterobacteria are high and worrying, and a way to minimize the accelerated emergence of resistance includes the development or improvement of techniques that generate diagnoses with high efficiency and speed.
Background The tracheostomized patients exhibit high risks of bacterial infections, because the tracheal tube acts as a gateway to these microorganisms. The objective was to characterize microbiologically the tracheal secretion of tracheostomized children, to evaluate the biofilm formation, and to study the phenotypic and molecular profile of antimicrobial resistance of Staphylococcus aureus and Pseudomonas aeruginosa isolated. Methods The study collected 88 tracheal secretion samples. The material processed by phenotypic tests were performed for bacterial identification. For identification of the biofilm, the Congo red agar test and the plaque microtiter test were used, and the qPCR method was used to resistance verification. Results Were obtained 27 samples of S. aureus and 71 of P. aeruginosa . All S. aureus samples were positive for biofilm formation on Congo red agar test. In antibiogram test, S. aureus showed resistance to seven drugs. Regarding the identification of resistance genes, were amplificated bla Z in 42.8% from S. aureus and mec A in 28.6% of them. Pseudomonas aeruginosa presented resistance to eight drugs. The most frequent chromosomal genes were bla OXA with 66.7% and bla KPC with 58.3%. To plasmidial DNA, was highlighted bla NDM with 58.3% positive. Conclusion The S. aureus and P. aeruginosa characterization of colonization from lower respiratory tract associated with the use of the device in tracheotomy patients, and the physiology and antimicrobial resistance profile, will help health professionals to choose the most appropriate treatment to be administered in children with tracheotomy, increasing the chances of airway restoration and decannulation.
Objective: The objective of this study was to microbiologically characterize the tracheal secretion of tracheostomized children, evaluate biofilm formation and study the phenotypic and molecular profile of the antimicrobial resistance of Sthapylococcus aureus and Pseudomonas aeruginosa isolates. Methods: 88 samples of tracheal secretions were collected. The material was processed to perform phenotypic tests and bacterial identification. Tests were used to identify biofilms using Congo red agar test and microdilution in a 96-well plate, and the qPCR method was used to verify resistance. Results: Twelve Staphylococcus aureus samples and 30 Pseudomonas aeruginosa were isolated of pediactric tracheostomized patients. All the S. aureus samples were positive to biofilm formation in Congo red agar test. In the antibiogram test, S. aureus showed resistance to seven antimicrobials. Regarding the identification of resistance genes, blaZ was amplified in 57.1% and mecA in 28.6% of the isolated S. aureus. Pseudomonas aeruginosa showed blaOXA with 66,7% e blaKPC with 58,3%. In plasmid DNA, blaNDM stood out with 58,3% positive. Conclusions: The control of resistant bacteria involved in biofilms in the stoma of tracheostomized patients is a great challenge, since the simple cannula change does not always allow the control of the microbiota, which increases the vulnerability of patients to future respiratory complications.
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