Multirresistant bacteria and their impacts on public health: A social responsability
DOI:
https://doi.org/10.33448/rsd-v10i6.16303Keywords:
Bacterial Drug Resistance; Bacterial Infections; Public health.Abstract
Introduction: Human beings coexist with numerous bacteria, but pathogenic species have plagued mankind for millennia until the advent of the first antibiotics. However, the indiscriminate use of antibiotics, both in hospitals and in agriculture, has generated high rates of bacterial resistance and has become a problem with imminent disruption. The present study aims to analyze the multifactorial etiology of bacterial multiresistance mechanisms, the prevalence of the main bacteria involved in this process and its impact on public health. Methodology: This is an integrative literature review about the processes and consequences of bacterial resistance. The inclusion criterion was compatibility with the theme and relevance. Results: 46 articles were analyzed, half of which are original articles. Among these, 6 articles carried out a survey of the prevalence of pharmacoresistant bacteria in nosocomial environments, with a sample of 646 patients in which Klebsiella pneumoniae was isolated in 27.11%, Pseudomonas aeruginosa in 19%, followed by Escherichia coli with 16%, and Staphylococcus aureus with 4.75%. Discussion: With 25 to 50% of antibiotic administrations in hospitals considered irregular, their indiscriminate use and the slow formulation of new therapeutic options, among others, contributed to the development of multidrug-resistant bacterial strains during the antimicrobial era. The main pharmacoresistance mechanisms include antibiotic modification; preventing the action of the antibiotic on its target; alteration of the primary binding site; and producing an alternative target to circumvent the drug's effect. Final Considerations: Bacterial multidrug resistance increases morbidity and mortality, length of hospital stay and expenses with supplies and specialized staff. It was established as a problem that tends to worsen over time, therefore, comprehensive studies focused on bacterial prevalence are necessary to outline public health strategies aimed at its control.
References
Abreu, M., Leite, J., Portela, A., Alves, V. & Almeida, R. (2016). Infeções Por Bactérias Multirresistentes em Idade Pediátrica: Estudo Retrospetivo de Sete Anos de um Hospital de Nível I. Acta Pediatr Port. 47,130-8.
Aguayo-Reyes, A., Quezada-Aguiluz, M., Mella, S., Riedel, G., Opazo-Capurro, A., Bello-Toledo, H., Dominguez, M. & González-Rocha, G. (2018). Bases moleculares de la resistencia a meticilina en Staphylococcus aureus. Rev Chilena Infectol. 35(1), 7-14.
Anselmo, D. B., Werle, C. H. & Hoffmann, F. L. (2015). Ocorrência de Escherichia coli e Staphylococcus aureus resistentes a antimicrobianos e parasitos Entamoeba coli e Ascaris lumbricoides em merendas escolares. Rev Inst Adolfo Lutz. 74(4), 399-409.
Basso, M. E., Pulcinelli, R. S. R., Aquino, A.R. C. & Santos, K. F. (2016). Prevalência de infecções bacterianas em pacientes internados em uma unidade de terapia intensiva (UTI). RBAC. 48(4), 383-8.
Bastos, F. C., & Loureiro E. C. B. (2010). Caracterização da resistência antimicrobiana de amostras de Shigella spp. isoladas em Belém, Estado do Pará, Brasil (1990-2000). Rev Pan-Amaz Saude,1(4):71-74.
Bertão, M. V., Furtado, I., Machado, A. & Reis, E. (2018). Estirpes Produtoras de Beta-Lactamases de Espectro Alargado: A Realidade num Hospital Central. Medicina Interna. 25(3), 179-185.
Bush, K. (1989). Characterization of β-lactamases. Antimicrob Agents Chemother. 33(3), 259-263.
Camou, T., Zunino, P. & Hortal, M. (2017). Alarma por la resistencia a antimicrobianos: situación actual y desafíos. Rev. Méd. Urug. 33(4), 104-127.
Chaguza, C., Cornick, J. E. & Everett, D. B. (2015). Mechanisms and impact of genetic recombination in the evolution of Streptococcus pneumoniae. Comput Struct Biotechnol J. 13(2015), 241–247.
Chen, D., Li, H., Zhao, Y., Qiu, Y., Xiao, L., He, H., Zheng, D., Li, X., Huang, L., Yu, X., Xu, N., Hu, X., Chen, Y. & Chen, F. (2020). Characterization of carbapenem‐resistant Klebsiella pneumoniae in a tertiary hospital in Fuzhou, China. Journal of Applied Microbiology. 129(5), 1220-1226.
Clardy, J., Fischbach, M. & Currie, C. (2009). The natural history of antibiotics. Curr Biol. 19(11), R437–R441.
Costa-Lourenço, A. P. R., Santos, K. T. B., Moreira, B. M., Fracalanzza, S. E. L. & Bonelli, R. R. (2017). Antimicrobial resistance in Neisseria gonorrhoeae: history, molecular mechanisms and epidemiological aspects of an emerging global threat. Braz J Microbiol [Internet]. 48(4), 617–628.
Debarba, E., Silvero, K. S. V., Teixeira, J. J. V., Silva, C. M. & Peder, L. D. (2017). Prevalência microbiana em secreções traqueais de pacientes em unidade de terapia intensiva - Experiência de 4 anos [ahead of print]. Journal of Infection Control. 7(1), 14.
Del Fio, F. S., Mattos Filho, T. R. & Groppo, F. C (2000). Resistência Bacteriana. Revista Brasileira de Medicina (Rio de Janeiro). 57(10), 1129-1140.
Djordjevic, Z. M., Folic, M. M. & Jankovic, S. M. (2017). Previous Antibiotic Exposure and Antimicrobial Resistance Patterns of Acinetobacter spp. and Pseudomonas aeruginosa Isolated from Patients with Nosocomial Infections. Balkan Med J. 34(6), 527-33.
Djouadi, L. N., Selama, O., Abderrahmani, A., Bouanane-Darenfed, A., Abdellaziz, L., Amziane, M., Fardeau, M. L. & Nateche, F (2017). Multiresistant opportunistic pathogenic bacteria isolated from polluted rivers and first detection of nontuberculous mycobacteria in the Algerian aquatic environment. J Water Health. 15(4), 566-579.
Gay, N., Leclaire, A., Laval, M., Miltgen, G., Jego, M., Stephane, R., Jaubert, J., Belmonte, O. & Cardinale, E (2018). Risk Factors of Extended-Spectrum β-Lactamase Producing Enterobacteriaceae Occurrence in Farms in Reunion, Madagascar and Mayotte Islands, 2016–2017. Vet Sci. 5(1), 22.
Hawkey, P. M. (1998). The origins and molecular basis of antibiotic resistance. BMJ [Internet]. 317(7159), 657-60.
Hughes, D (2014). Selection and evolution of resistance to antimicrobial drugs. IUBMB Life. 66(8), 521-529.
Kapadia, S. N., Abramson, E. L., Carter, E. J., Loo, A. S., Kaushal, R., Calfee, D. P. & Simon, M. S (2018). The Expanding Role of Antimicrobial Stewardship Programs in Hospitals in the United States: Lessons Learned from a Multisite Qualitative Study. Jt Comm J Qual Patient Saf. 44(2), 68-74.
Lima, M. F. P., Borges, M. A., Parente, R. S., Victória Júnior, R. C. & Oliveira, M. E. (2018). Staphylococcus aureus e As Infecções hospitalares Hospitalares - Revisão de Literatura. Revista UNINGÁ Review. 21(1), 32-39.
Lima, V. S. (2018). Avaliação das culturas de vigilância em pacientes sob risco de colonização por bactérias multirresistentes à admissão hospitalar (Monografia). [Aracaju]: Universidade Federal do Sergipe. 51 p. https://ri.ufs.br/handle/riufs/7863
Liu, M., Ma, J., Jia, W. & Li, W. (2020). Antimicrobial Resistance and Molecular Characterization of Gene Cassettes from Class 1 Integrons in Pseudomonas aeruginosa Strains [ahead of print, 2020 May 14]. Microb Drug Resist. 2020,10.1089/mdr.2019.0406. 10.1089/mdr.2019.0406
Loureiro, R. J., Roque, F., Rodrigues, A. T., Herdeiro, M. T. & Ramalheira, E (2016). O uso de antibióticos e as resistências bacterianas: breves notas sobre a sua evolução. Rev. Port. Sau. Pub. 34(1), 77-84.
Machado, G. M., Lago, A., Fuentefria, S. R. R. & Fuentefria, D. B. (2011). Occurrence and the susceptibility to antimicrobial agents in Pseudomonas aeruginosa and Acinetobacter sp. at a tertiary hospital in southern Brazil. Rev. Soc. Bras. Med. Trop. 44(2), 168-172.
Miquet, G. (2017). Resistencia a los antimicrobianos. Revista de Investigaciones Agropecuarias. 43(1), 3.
Mota, F. S., Oliveira, H. A. & Souto, R. C. F. (2018). Perfil e prevalência de resistência aos antimicrobianos de bactérias Gram-negativas isoladas de pacientes de uma unidade de terapia intensiva. RBAC. 50(3), 270-7.
Mota, L., Vilar, F., Dias, L., Nunes, T. & Moriguti, J. (2010). Uso racional de antimicrobianos. Medicina (Ribeirao Preto Online). 43(2), 164-72.
Nishino, K., Latifi, T. & Groisman, E. A. (2006). Virulence and drug resistance roles of multidrug efflux systems of Salmonella enterica serovar Typhimurium. Molecular Microbiology. 59(1), 126–141.
Oliveira, C. B. S., Dantas, V. C. R., Motta Neto, R., Azevedo, P. R. M. & Melo, M. C. N. (2011). Frequência e perfil de resistência de klebsiella spp. em um hospital universitário de Natal/RN durante 10 anos. J. Bras. Patol. Med. Lab. 47(6), 589-594.
Padiyara, P., Inoue, H. & Sprenger, M. (2018). Global Governance Mechanisms to Address Antimicrobial Resistance. Infect Dis (Auckl). 11, 1-4.
Pons, M. J., Toro, M., Medina, S., Saens, Y. & Ruiz, J. (2020). Antimicrobial agentes, antibacterial resistance and susteinable health. South Soustenability. 1(1), e001.
Powers, J. H., Evans, S. R. & Kesselheim, A. S. (2018) Studying new antibiotics for multidrug resistant infections: are today’s patients paying for unproved future benefits? BMJ. 360, k587.
Ribas, A. C. (2018). Prevalência de infecções em idosos internados em uma unidade de terapia intensiva (Monografia). [Passo Fundo]: Universidade Federal da Fronteira Sul. 67 p. https://rd.uffs.edu.br/handle/prefix/3091
Rueda, J., Realpe, T., Mejia, G., Zapata, E. & Robledo, J. (2015). GenoType MTBDRplus 1.0® para la detección de resistencia cruzada entre isoniacida y etionamida en aislamientos de Mycobacterium tuberculosis multirresistentes. Biomédica. 35(4), 541-8.
Sabathier, L. L. Estudio de resistência a antibióticos del gênero Pseudomonas em muestras de agua del rio Limay [Dissertação de Mestrado]. [Comahue]: Universidad Nacional del Comahue, 2019. 51 p.
Salam, L. B (2020). Unravelling the antibiotic and heavy metal resistome of a chronically polluted soil. 3 Biotech. 10(238), 23 p.
Santos, I. A. L., Nogueira, J. M. R. & Mendonça, F. C. R. (2015). Mecanismos de resistência antimicrobiana em Pseudomonas aeruginosa. RBAC. 47(1-2), 512.
Seibert, G., Hörner, R., Meneghetti, B. H., Righi, R. A., Forno, N. L. F. & Salla, A. (2014). Infecções Hospitalares por enterobactérias produtoras de Klebsiella pneumoniae carbapenemase em um hospital escola. Einstein (São Paulo). 12, (3), 282-6.
Silva, T., Nogueira, P. A., Magalhães, G. F., Grava, A. F., da Silva, L. H. P. & Orlandi, P. P. (2008). Characterization of Shigella spp. by antimicrobial resistance and PCR detection of ipa genes in an infantile population from Porto Velho (Western Amazon region), Brazil. Mem Inst Oswaldo Cruz, Rio de Janeiro,103(7): 731-733.
Soares, C. R. P., Oliveira-Júnior, J. B., & Firmo, E. F. (2021). Primeiro relato de um gene resistente ao blaNDM em um isolado clínico de Klebsiella aerogenes do Brasil. Revista da Sociedade Brasileira de Medicina Tropical. 54, e02622020.
Souza, E. S., Belei, R. A., Carrilho, C. M. D. M., Matsuo, T., Yamada-ogatta, S. F., Andrade, G., Perugini, M. R. E., Pieri, F. M., Dessunti, E. M. & Kerbauy, G. (2015). Mortalidade e riscos associados à infecção relacionada à assistência à saúde. Texto Contexto Enferm. 24(1), 220-8.
Souza, M. V., Reis, C. & Pimenta, F. C. (2005). Revisão sobre aquisição gradual de resistência de Staphylococcus aureus aos antimicrobianos. Revista de Patologia Tropical. 34(1), 27-36.
Tanwar, J., Das, S., Fatima, Z. & Hameed, S. (2014). Multidrug Resistance: An Emerging Crisis. Interdisciplinary Perspectives On Infectious Diseases. 2014, (541340), 1-7.
Tenover, F. C. (2006). Mechanisms of Antimicrobial Resistance in Bacteria. Am J Med. 119(6), S3-10, S62-70.
Vieira, P. N. & Vieira, S. L. V. (2017). Uso irracional e resistência a antimicrobianos em hospitais. Arq. Cienc. Saúde UNIPAR. 21(3), 209-212.
Wi, T., Lahra, M. M., Ndowa, F., Bala, M., Dillon, J. R., Ramon-Pardo, P., Eremin, S. R., Bolan, G. & Unemo, M. (2017). Antimicrobial resistance in Neisseria gonorrhoeae: Global surveillance and a call for international collaborative action. PLoS Med. 14(7), e1002344.
Zagui, G. S., Tonani, K. A. A., Fregonesi, B. M., Machado, G. P., Silva, T. V., Andrade, L. N., Andrade, D., & Segura-Muñoz, S. I. (2021). Esgoto hospitalar terciário como reservatório de bactérias expressando o fenótipo MDR no Brasil. Jornal Brasileiro de Biologia. 82, e234471.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Juliana Jeanne Vieira de Carvalho; Felipe Gomes Boaventura; Anitha de Cássia Ribeiro da Silva; Rhuana Lima Ximenes; Luana Kamila Castilho Rodrigues; Diego Antônio de Almeida Nunes; Viviane Krominski Graça de Souza
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.