Avaliação do perfil e da resistência bacteriana nos efluentes de um hospital em Itajaí/Santa Catarina




Throughout history, bacterial infections associated with a lack of basic sanitation have been the cause of many public health problems. With the development of science and improvements in technologies for treating water and sewage, the control of the spread of water-borne diseases became more efficient. Moreover, the discovery and use of antibiotics also favored the control and treatment of bacterial infections. However, with the use of these drugs, it was found out that bacteria are able to develop strategies of antimicrobial resistance, leading to strains of bacteria which are difficult to treat, and which can, in many cases, lead to the death of the patient This research therefore studies the bacterial profile isolated from samples of effluent and sludge taken from the Sewage Treatment System of a hospital in the city of Itajaí - SC, and seeks to determine the resistance of these bacteria to antibiotics. Another objective was to compare the resistance of bacterial strains from this Sewage Treatment System with those isolated from community and hospital infections, at the hospital that was object of this study. Two samplings were carried out (November 2006 and March 2007) from the Sewage Treatment System of the hospital, which is a biological septic tank system, in three different locations. Sampling was carried out at the raw sewage, sludge and treated effluent points. 133 bacteria were isolated belonging to the Enterobacteriaceae family (Escherichia coli, Klebsiella spp., Citrobacter sp., etc.), the non-enterobacteria group (Aeromonas spp., Pseudomonas sp., etc.) and the Streptococcaceae (Enterococcus sp., etc.) and Micrococaceae (Staphylococcus sp.) families. Of these, 130 were subjected to the Antimicrobial Sensitivity Test (AST) as proposed by the NCCLS. The Enterobacteriaceae family showed the highest sensitivity, with 50.1% of the antibiotics tested, compared with the other families. In relation to the resistance of the strains isolated in the effluent, the group of non-enterobacteria and the Streptococcaceae and Micrococcaceae families showed resistance to the drugs tested of over 50%. A strain of Pseudomonas aeruginosa isolated from the effluent showed resistance to all the antibiotics tested. In the hospital clinic, 435 bacteria were identified which cause nosocomial infections and community infections, from January 2006 to May 2007. Regarding the sensitivity profile of all families of bacteria investigated, a level of sensitivity of more than 75% was found, the family with the highest level of resistance being the Micrococcaceae, with 23.6%. Comparing the results, it was observed that the bacteria from the hospital effluent had higher levels of multidrug resistance than the bacteria of clinical origin. Thus, it is concluded that there is a need to improve the Sewage Treatment System of the hospital in question, as in relation to the microbiological parameters, it does not fulfill the provisions of CONAMA resolution 357/2005. The presence of multiresistant bacteria and the presence of Pseudomonas aeruginosa which is resistant to all drugs tested signal the danger of ineffective treatment of hospital effluent


perfil microbiológico nosocomial infection antimicrobianos bacterial resistance efluente hospitalar turismo resistência bacteriana microbiological wastewater profile infecção hospitalar resistance to antibiotics hospital effluent multirresistência

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