Resist?ncia bacteriana em reservat?rio do semi?rido brasileiro: caracteriza??o, a??o para vigil?ncia ambiental, preven??o e educa??o em sa?de

• Main Author: Nascimento, Ermeton Duarte do
• Other Authors: 51274957400
• Language: Portuguese
• Published: PROGRAMA DE P?S-GRADUA??O EM DESENVOLVIMENTO E MEIO AMBIENTE - PRODEMA 2016
• Subjects: CNPQ::CIENCIAS BIOLOGICAS: EM DESENVOLVIMENTO E MEIO AMBIENTE - PRODEMA; Contamina??o aqu?tica; Semi?rido; Resist?ncia antimicrobiana; MAR
• Online Access: https://repositorio.ufrn.br/jspui/handle/123456789/21440

Submitted by Automa??o e Estat?stica ([e-mail]) on 2016-10-11T23:01:26Z No. of bitstreams: 1 ErmetonDuarteDoNascimento_TESE.pdf: 7719427 bytes, checksum: b84ff037c2d66bf7a8b825c76b7b9db3 (MD5) === Approved for entry into archive by Arlan Eloi Leite Silva ([e-mail]) on 2016-10-18T00:19:26Z (GMT) No. of bitstreams: 1 ErmetonDuarteDoNascimento_TESE.pdf: 7719427 bytes, checksum: b84ff037c2d66bf7a8b825c76b7b9db3 (MD5) === Made available in DSpace on 2016-10-18T00:19:26Z (GMT). No. of bitstreams: 1 ErmetonDuarteDoNascimento_TESE.pdf: 7719427 bytes, checksum: b84ff037c2d66bf7a8b825c76b7b9db3 (MD5) Previous issue date: 2016-04-29 === Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq) === Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) === A resist?ncia aos antimicrobianos se transformou num s?rio problema de sa?de p?blica mundial e v?rios ambientes aqu?ticos se apresentam contaminados por esses microrganismos. Entretanto, n?o h? dados sobre esse fen?meno para o semi?rido brasileiro. Sendo assim, este estudo teve como objetivo o isolamento e a identifica??o das bact?rias de import?ncia m?dica contaminantes de ambientes qu?ticos no semi?rido potiguar, a caracteriza??o da resist?ncia antimicrobiana, e a formula??o de propostas para educa??o em sa?de e a??es para vigil?ncia ambiental em sa?de. Com este prop?sito foram coletadas amostras de ?gua de quatro reservat?rios do semi?rido potiguar durante os per?odos seco e chuvoso. As amostras foram processadas e os microrganismos foram isolados e identificados seguindo orienta??es de bibliografias especializadas. Em seguida foram realizados os testes de sensibilidade antimicrobiana em disco difus?o, calculado o ?ndice de m?ltipla resist?ncia antibi?tica (MAR) e classificados os organismos com multipla resist?ncia ?s drogas (MDR). Tamb?m foram propostas a??es para preven??o e educa??o em sa?de, bem como para vigil?ncia ambiental em sa?de. Adicionalmente, foi avaliada, na Universidade de Minnesota, nos Estados Unidos, a influ?ncia da concentra??o do f?sforo em meio l?quido (caldo nutriente, C:P 100:1, 1000:1 e 100.000:1) sobre a expres?o fenot?pica da resist?ncia ? tetraciclina, ao cloranfenicol e a eritromicina, de 41 cepas bacterianas dos Estados Unidos utilizando a t?cnica da Concentra??o Inibit?ria M?nima (CIM) e da Concentra??o Bactericida M?nima (CBM). Ao todo foram isoladas 168 bact?rias, 56% no per?odo chuvoso, com 97,6% pertecentes ao grupo das Gram-negativas, com a Fam?lia Enterobacteriaceae apresentando a maior preval?ncia entre esse grupo (73,2%). 95,3% das bact?rias resistentes aos antimicrobianos foram isoladas durante o per?odo seco e o ?ndice MAR foi maior no reservat?rio Passagem das Tra?ras, com 56% de chance para que as bact?rias encontradas na ?gua desse reservat?rio procedam de uma fonte de contamina??o com maior risco para a sa?de humana. N?o houve diferen?a estat?stica da ocorr?ncia de g?neros e esp?cies bacterianos entre os per?odos seco e chuvoso e nem entre os reservat?rios, com p=0,255. Tamb?m n?o houve diferen?a estat?stica do ?ndice MAR entre os per?odos e os reservat?rios, com p=0,224. Quando avaliada a CIM, o meio com C:P de 100.000:1, considerado com a menor concentra??o de f?sforo, parece aumentar a sensibilidade das bact?rias ao cloranfenicol e a eritromicina quando comparado aos resultados do caldo nutriente para os mesmos antimicrobianos, com um p=0,023. Nas escolas que atendem as comunidades ribeirinhas usu?rias da ?gua dos reservat?rios, s?o propostas a??es de educa??o em sa?de que visem o levantamento de concep??es sobre o conhecimento do uso dos antimicrobianos e do surgimento da resist?ncia bacteriana a essas drogas, bem como o desenvolvimento de material para educa??o em sa?de. E no n?cleo de Vigil?ncia Ambiental em Sa?de da SESAP, s?o propostas a inclus?o das bact?rias resistentes aos antimicrobianos isoladas de ambientes aqu?ticos como indicadores de risco para a sa?de p?blica, a formula??o de pol?ticas p?blicas visando o controle das atividades que contaminam esses recursos com esses organismos e tamb?m o monitoramento peri?dico da ?gua dos diversos ambientes aqu?ticos. === Bacterial resistance to antimicrobials became a serious public health problem around the world, and different aquatic environments are contaminated with these organisms. However, there is no data about this phenomenon in the Brazilian semiarid region. Therefore, this study had as main the isolation and identification of contaminant harmful bacteria of potiguar semiarid aquatic environments, characterization of antimicrobial resistance, development of proposals in health education and actions for environmental health surveillance. With this purpose were collected water samples from four potiguar semiarid reservoirs during dry and rainy season. Those samples were analyzed and microorganisms were isolated and identified following specialized literature orientation. Then antimicrobials susceptibility disk diffusion test were performed, Multiple Antibiotic Resistance (MAR) index was calculated, and Multiple Drug Resistance (MDR) classification was used. Also were proposed actions for health prevention and education. In addiction, was evaluated, in Minnesota University/United States of America, the influence of phosphorus concentration in broth medium (Nutrient broth, 100:1, 1000:1 and 100.000:1 C:P ratio) over phenotypic resistance expression to tetracycline, chloramphenicol and erythromycin in 41 American aquatic bacterial strains by using Minimal Inhibitory Concentration (MIC) and Minimal Bactericidal Concentration (MBC) techniques. Altogether were isolated 168 bacteria from the Brazilian semiarid reservoirs, 56% in rainy season, with 97,6% from Gram-negative group, and 73,2% from Enterobacteriaceae Family. Ninety five point three percent of antimicrobial resistant bacteria were isolated during dry season and MAR index was higher for Passagem das Tra?ras reservoir, with 56% of chance that bacteria found in that reservoir has proceeded from high risk source of contamination for human health. There were no statistical differences of bacterial genera and species occurrence between dry and rainy season nor between reservoirs, with p=0,255. Also, there were no statistical differences in MAR index between seasons nor between reservoirs, with p=0,244. When MIC was evaluated, the 100.000:1 C:P ratio medium, considered the one with lower concentration of phosphorus, seemed to increase bacterial susceptibility to chloramphenicol and erythromycin when comparing to nutrient broth results for the same antimicrobials, with p=0,023. At schools that serve riverine communities water reservoirs user were proposed activities for health education aiming describe conceptions about antimicrobial use knowledge and the emergency of bacterial resistance to those drugs, as well as the development of materials for health education. At SESAP Environmental Health Surveillance group were proposed inclusion of antimicrobial resistant bacteria isolated in aquatic environments as indicator of risk for public health, as well as formulation of public policies to control activities that contaminate these sources with those organisms, and also the water periodic monitoring of several aquatic environments.