Prevalência de bastonetes gram-negativos isolados da nasofaringe de crianças de creches do município de Goiânia / Prevalence of gram-negative rods isolated from the nasopharynx of children in daycare centers in Goiânia

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

Introduction: the nasopharynx (NP) constitutes the primary ecological reservoir or source of dissemination of microorganisms as Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus and Gram-negative bacilli (GNB). Several studies demonstrated that asymptomatic nasopharyngeal (NP) carriage of pathogens is prevalent in young infants and precedes the development of invasive disease. Children in day-care centers act as an important vector for horizontal spread of the respiratory pathogens and GNB within the community. The infants are susceptible to condition of carrier and take a fundamental role in the epidemiology of respiratory infections. The nasopharyngeal flora becomes established during the first year of life and is densely colonized by a broad variety of microorganisms, commensal bacteria as well as potential pathogens that may cause infections. Epidemiologic studies demonstrate that many factors influence nasopharyngeal carriage rates: age, gender, season, acute respiratory illness, exposure to other children, socio-economic status, family size, warm-climate countries, passive smoking exposure, antibiotic therapy are risk factors of colonization of the NP by BGN. Objective: this study aimed to determinate the prevalence and susceptibility pattern of BGN isolated from NP of children less than five years old attending day-care centers at municipality of Goiânia. Methods: the investigation was conducted in the municipality of Goiânia as part of an ongoing prospective surveillance of Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus in children of 62 day-care centers. The surveillance was carried out from August to December, 2005 and was collected 1192 samples. The nasopharyngeal specimens were collected with a transwab, extrathin and flexible, placed in Stuart transport medium tubes and transported to the Laboratory of Bacteriology of the Federal University of Goias-Institute of Tropical Pathology and Public Health to processing. The isolates were identified by colony morphology, Gram staining technique and according to standardized tests. Susceptibility tests were performed by the disk diffusion method. Results: a total of 106 (8,9%) Gram-negative bacilli were isolated and 13 species were identified. The species more prevalent were twenty-six (24,5%) Enterobacter aerogenes, seventeen (16,0%) K. pneumoniae, eleven (10,4%) E. coli, eight (7,5%) E. agglomerans and five (4,7%) Pseudomonas sp. It was observed that forty-three (57,3%) GNB were resistant to ampicillin; twenty (26,7%) to trimethoprim-sulfametoxazole; eighteen (24,0%) showed resistance to amoxicillin-clavulanic acid and nine (12,0%) presented resistance to tetracycline. The production of extended-spectrum beta-lactamase was not detected. Conclusion: in this study was demonstrated that young children attending in daycare centers at municipality of Goiania might be GNB carrier and therefore have a fundamental role in the dissemination of microorganisms involved in community-acquired infections. It is necessary that more studies be developed to establish strategies more effectives to minimize the problem of the nasopharyngeal colonization and communityacquired infections due to importance and seriousness that both represent in the public health.

ASSUNTO(S)

bgn gnb, nasopharyngeal colonization, infants, nursey medicina colonização nasofaríngea creches crianças

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