Suscetibilidade antimicrobiana de Streptococcus agalactiae isolados de gestantes em um hospital materno infantil de Porto Alegre, Rio Grande do Sul
DOI:
https://doi.org/10.15448/1980-6108.2018.3.30246Palavras-chave:
Streptococcus agalactiae, estreptococos do grupo B, gestantes, antibacterianos, antibioticoprofilaxia, resistência microbiana a medicamentos.Resumo
OBJETIVOS: Caracterizar o perfil de suscetibilidade antimicrobiana de Streptococcus agalactiae isolados de gestantes atendidas em um hospital público.
MÉTODOS: O estudo foi realizado em um hospital materno-infantil público de Porto Alegre, RS, no qual a pesquisa de S. agalactiae em gestantes faz parte da rotina obstétrica. Foram incluídas no estudo as pesquisas por swab anal/vaginal realizadas no período de julho de 2015 a fevereiro de 2016. Os isolados bacterianos foram identificados por testes fenotípicos e foi determinada a suscetibilidade aos antimicrobianos ampicilina, clindamicina, eritromicina e ofloxacino. Foram investigados também os genes de resistência à eritromicina ermB e mefA.
RESULTADOS: No total, 294 coletas foram incluídas e destas, 26 (8%) foram positivas para S. agalactiae. Todos os isolados avaliados foram sensíveis à ampicilina e foram observadas resistências à eritromicina (21,4%), clindamicina (14,3%) e ofloxacino (7,1%), sendo que 66% dos isolados resistentes à eritromicina apresentaram o genótipo mefA.
CONCLUSÕES: Os resultados deste estudo corroboram com o consenso de que em gestantes colonizadas com S. agalactiae é aconselhada a antibioticoprofilaxia intraparto com penicilina G ou ampicilina. A expressiva proporção de isolados resistentes à eritromicina e clindamicina, indicados para a antibioticoprofilaxia intraparto em caso de alergia aos antibióticos beta-lactâmicos, enfatiza a importância da determinação do perfil de suscetibilidade antimicrobiana prévia desses isolados, medida que ainda não faz parte da rotina de exames pré-natais em muitas instituições.
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