Características clínicas e Esquema de Tratamento Medicamentoso de Infecções por Staphylococcus aureus: uma possível proposta de identificação para o laboratorista e tratamento para o clínico
DOI:
https://doi.org/10.25119/praxis-3-5-971Palavras-chave:
METHICILLIN-RESISTANT Staphylococcus aureus, colonização nasal, infecção, genótipos.Resumo
A área de ensino, no decorrer de sua trajetória histórica, tem se deparado com problemas de diversas ordens, como por exemplo: a formação de professores e em decorrência na formação dos profissionais da área da saúde. Ao considerar que a formação docente ainda é caracterizada por um viés conteudista, distante da experimentação, acarreta consequências no campo do ensino, pois os mesmos discentes que outrora obtiveram lacunas em sua formação, na atualidade militam no campo da docência em múltiplos campos do saber reproduzindo tais práticas descontextualizadas. Para entender a prática docente e como modificá-la, alguns estudos consideram a importância da perspectiva do professor investigador e as necessidades formativas indispensáveis para a melhoria do ensino de Ciências. Em função da abrangência destes aspectos, há necessidade de se aliar os conhecimentos específicos de variados campos do saber, os aspectos metodológicos diversificados e os princípios históricos e epistemológicos da construção do conhecimento científico. Portanto, sabendo das lacunas que envolvem o processo de formação do laboratorista esse artigo tem como objetivo discutir uma proposta de identificação clínica para laboratorista, mais especificamente para o Staphylococcus aureus, na intenção de servir como um material didático para minizar tais impactos no processo de formação de tais profissionais. O Staphylococcus aureus é bem conhecido pela sua capacidade para adquirir genes de resistência a drogas antimicrobianas. Este patógeno é historicamente associado a infecções relacionadas à assistência à saúde e pode se disseminar rapidamente entre os indivíduos saudáveis. Surtos de infecções causadas por cepas de Staphylococcus aureus resistente a meticilina associados a comunidade (CA-MRSA) têm sido relatados em todo o mundo, incluindo o Brasil, onde existe atualmente uma epidemia de CA-MRSA. Pensando nesta problemática, apresentamos aqui, uma revisão sobre a utilização adequada das metodologias fenotípicas e genotípicas de caracterização dos isolados de Staphylococcus aureus de grande importância no ambiente hospitalar, assim como a caracterização clínica das doenças estafilocócicas e o tratamento medicamentoso adequado para combater estas infecções de maneira rápida e de acordo com as modificações por aquisição, por este organismo, de mecanismos de resistência.
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Referências
Allegranzi, B. et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet, 377(9761), 228- 241, 2011.
Balaban, N. et al. Autoinducer of virulence as a target for vaccine and therapy against Staphylococcus aureus. Science, 280(5362), 438-440, 1998.
Berglund, C.; Molling, P.; Sjoberg, L. and Soderquist, B. Predominance of staphylococcal cassette chromosome mec (SCCmec) type IV among methicillin-resistant Staphylococcus aureus (MRSA) in a Swedish county and presence of unknown SCCmec types with Panton-Valentine leukocidin genes. (2005) Clin Microbiol Infect. 11(6), 447-456.
Boyle-Vavra S, Daum RS. Community-acquired methicillin-resistant Staphylococcus aureus: the role of Panton-Valentine leukocidin. Lab Invest 2007; 87:3-
Chambers & Deleo; Waves of resistance: Staphylococcus aureus in the antibiotic era; (2009)
Chambers, H.F. and Deleo, F.R. Waves of resistance: Staphylococcus aureus in the antibiotic era. (2009) Nat Rev Microbiol. 7(9), 629-641.
Conly, J.M. and Johnston, B.L. The emergence of methicillin- resistant Staphylococcus aureus as a community- acquired pathogen in Canada. (2003) Can J Infect Dis. 14(5), 249-251.
Dancer, S.J. The effect of antibiotics on methicillinresistant Staphylococcus aureus. (2008) J Antimicrob Chemother. 61(2), 246-253.
Deurenberg, R.H. and Stobberingh, E.E. The evolution of Staphylococcus aureus. (2008) Infect Genet Evol. 8(6), 747-763.
Deurenberg, R.H. and Stobberingh, E.E. The molecular evolution of hospital- and community-associated methicillin-resistant Staphylococcus aureus. (2009) Curr Mol Med. 9(2), 100-115.
dos Santos Soares, M.J.; da Silva-Carvalho, M.C.; Ferreira- Carvalho, B.T. and Figueiredo, A.M. Spread of methicillin-resistant Staphylococcus aureus belonging to the Brazilian epidemic clone in a general hospital and emergence of heterogenous resistance to glycopeptide antibiotics among these isolates. (2000) J Hosp Infect. 44(4), 301-308.
Fortes, C.Q.; Espanha, C.A.; Bustorff, F.P.; Zappa, B.C.; Ferreira, A.L.; Moreira, R.B.; Pereira, N.G.; Fowler, V.G., Jr. and Deshmukh, H. First reported case of infective endocarditis caused by community-acquired methicillin-resistant Staphylococcus aureus not associated with healthcare contact in Brazil. (2008) Braz J Infect Dis. 12(6), 541-543.
Fowler, V.G., Jr.; Miro, J.M.; Hoen, B.; Cabell, C.H.; Abrutyn, E.; Rubinstein, E.; Corey, G.R.; Spelman, D.; Bradley, S.F.; Barsic, B.; Pappas, P.A.; Anstrom, K.J.; Wray, D.; Fortes, C.Q.; Anguera, I.; Athan, E.; Jones, P.; van der Meer, J.T.; Elliott, T.S.; Levine, D.P. and Bayer, A.S. Staphylococcus aureus endocarditis: a consequence of medical progress. (2005) JAMA. 293(24), 3012-3021.
Franklin R. Cockerill; Mathew A. Wikler; Karen Bush; Michael N. Dudley; George M. Eliopoulos; Dwight J. Hardy; David W. Hecht; Janet A. Hindler; Jean B. Patel; Mair Powel; Richard B. Thomson Jr.; John D. Turnide; Melvin P. Weinstein; Barbara L. Zilmmer; Mary Jane Ferraro; Jana M. Zwenson. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-First Informational Supplement. (2011) Clinical and Laboratory Standards Institute.
Grothe, C.; Belasco A.G.S.; Bittencourt, A.R.C.; Vianna L.A.C.; Sesso, R.C.C.; Barbosa, D.A. Incidence of Bloodstream Infection Among Patients on Hemodialysis by Centrous Venous Catheter. Rev. Latino-Am. Enfermagem Jan-Feb 2010; 18(1): 73-80.
Guzmán-Blanco M, Mejía C, Isturiz R et al. Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in Latin America. Int J Antimicrob Agents. 2009; 34 (4): 304-308.
Ito, T.; Ma, X.X.; Takeuchi, F.; Okuma, K.; Yuzawa, H. and Hiramatsu, K. Novel type V staphylococcal cassette chromosome mec driven by a novel cassette chromosome recombinase, ccrC. (2004) Antimicrob Agents Chemother. 48(7), 2637-2651.
Katayama, Y.; Ito, T. and Hiramatsu, K. A new class of genetic element, staphylococcus cassette chromosome mec,encodes methicillin resistance in Staphylococcus aureus. (2000) Antimicrob Agents Chemother. 44(6), 1549-1555.
Kondo, Y.; Ito, T.; Ma, X.X.; Watanabe, S.; Kreiswirth, B.N.; Etienne, J. and Hiramatsu, K. Combination of multiplex PCRs for staphylococcal cassette chromosome mec type assignment: rapid identification system for mec, ccr, and major differences in junkyard regions. (2007) Antimicrob Agents Chemother. 51(1), 264-274.
Lina G, et al. Involvement of Panton-Valentine leukocidinproducing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis, 29: 1128 – 1132, 1999.
Lindsay, J. A.; Holden, M. T. Staphylococcus aureus: superbug, super genome? Trends Microbiol, 12(8), 378-385, 2004.
Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicilin- Resistant Staphylococcus aureus infections in adults and children. Clinical Infectious Diseases 2011; 52: 1-38.
Lo, W.T. and Wang, C.C. Panton-Valentine leucocidin in the pathogenesis of community-associated methicillin- resistant Staphylococcus aureus infection. (2011) Pediatr Neonatol. 52(2), 59-65.
Lu, P. L. et al. Risk factors and molecular analysis of community methicillin-resistant Staphylococcus aureus carriage. J Clin Microbiol, 43(1), 132-139, 2005.
N.Gardella; S.Murzicato; S. Di Gregorio; A. Cuirolo; J.Desse; F. Crudo; G.Gutking; M. Mollerach. Prevalence and Characterization of methicilin- resistent Sthaphylococcus aureus among healthy children in city of Argentina. Infection, Genetics and Evolution 11 (2011) 1066-1071
Okuma. K. et al. Dissemination of new methicillinresistant Staphylococcus aureus clones in the community. J Clin Microbiol, 40: 4289 – 4294, 2002.
Oliveira, D.C.; Tomasz, A. and de Lencastre, H. The evolution of pandemic clones of methicillin-resistant Staphylococcus aureus: identification of two ancestral genetic backgrounds and the associated mec elements. (2001) Microb Drug Resist. 7(4), 349-361.
Oliveira, G.A.; Faria, J.B.; Levy, C.E. and Mamizuka, E.M. Characterization of the Brazilian endemic clone of methicillin-resistant Staphylococcus aureus (MRSA) from hospitals throughout Brazil. (2001) Braz J Infect Dis. 5(4), 163-170.
Otto, M. A MRSA-terious enemy among us: end of the PVL controversy? (2011) Nat Med. 17(2), 169-170.
Ramos, R.L.; Teixeira, L.A.; Ormonde, L.R.; Siqueira, P.L.; Santos, M.S.; Marangoni, D. and Figueiredo, A.M. Emergence of mupirocin resistance in multiresistant Staphylococcus aureus clinical isolates belonging to Brazilian epidemic clone III::B:A. (1999) J Med Microbiol. 48(3), 303-307.
Rizek, C.F.; Matte, M.H.; Dropa, M.; Mamizuka, E.M.; de Almeida, L.M.; Lincopan, N.; Matte, G.R. and Germano, P.M. Identification of Staphylococcus aureus carrying the mecA gene in ready-to-eat food products sold in Brazil. (2011) Foodborne Pathog Dis. 8(4), 561-563.
Robinson, D.A. and Enright, M.C. Multilocus sequence typing and the evolution of methicillin-resistant Staphylococcus aureus. (2004) Clin Microbiol Infect. 10(2), 92-97.
Rodriguez-Noriega, E.; Seas, C.; Guzman-Blanco, M.; Mejia, C.; Alvarez, C.; Bavestrello, L.; Zurita, J.; Labarca, J.; Luna, C.M.; Salles, M.J. and Gotuzzo, E. Evolution of methicillin-resistant Staphylococcus aureus clones in Latin America. (2010) Int J Infect Dis. 14(7), e560-566.
ALLEGRANZI B. et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet, 377(9761), 228-241, 2011.
BALABAN , N. et al. Autoinducer of virulence as a target for vaccine and therapy against Staphylococcus aureus. Science, 280(5362), 438-440, 1998.
BERGLUND , C.; Molling, P.; Sjoberg, L. and Soderquist, B. Predominance of staphylococcal cassette chromosome mec (SCCmec) type IV among methicillin-resistant Staphylococcus aureus (MRSA) in a Swedish county and presence of unknown SCCmec types with Panton-Valentine leucocidin genes. (2005) Clin Microbiol Infect. 11(6), 447-456.
BOYLE -VAVRA S, Daum RS. Community-acquired methicillin-resistant Staphylococcus aureus: the role of Panton-Valentine leukocidin. Lab Invest 2007; 87:3-
CHAMBERS & Deleo; Waves of resistance: Staphylococcus aureus in the antibiotic era; (2009)
CHAMBERS , H.F. and Deleo, F.R. Waves of resistance: Staphylococcus aureus in the antibiotic era. (2009) Nat Rev Microbiol. 7(9), 629-641.
CONLY , J.M. and Johnston, B.L. The emergence of methicillin-resistant Staphylococcus aureus as a community- acquired pathogen in Canada. (2003) Can J Infect Dis. 14(5), 249-251.
DANCER , S.J. The effect of antibiotics on methicillin- resistant Staphylococcus aureus. (2008) J Antimicrob Chemother. 61(2), 246-253.
DEURENBERG , R.H. and Stobberingh, E.E. The evolution of Staphylococcus aureus. (2008) Infect Genet Evol. 8(6), 747-763.
DEURENBERG , R.H. and Stobberingh, E.E. The molecular evolution of hospital- and community-associated methicillin-resistant Staphylococcus aureus. (2009) Curr Mol Med. 9(2), 100-115.
DOS SANTOS SOARES , M.J.; da Silva-Carvalho, M.C.; Ferreira-Carvalho, B.T. and Figueiredo, A.M. Spread of methicillin-resistant Staphylococcus aureus belonging to the Brazilian epidemic clone in a general hospital and emergence of heterogenous resistance to glycopeptide antibiotics among these isolates. (2000) J Hosp Infect. 44(4), 301-308.
FORTES , C.Q.; Espanha, C.A.; Bustorff, F.P.; Zappa, B.C.; Ferreira, A.L.; Moreira, R.B.; Pereira, N.G.; Fowler, V.G., Jr. and Deshmukh, H. First reported case of infective endocarditis caused by communityacquired methicillin-resistant Staphylococcus aureus not associated with healthcare contact in Brazil. (2008) Braz J Infect Dis. 12(6), 541-543.
FOWLER , V.G., Jr.; Miro, J.M.; Hoen, B.; Cabell, C.H.; Abrutyn, E.; Rubinstein, E.; Corey, G.R.; Spelman, D.; Bradley, S.F.; Barsic, B.; Pappas, P.A.; Anstrom, K.J.; Wray, D.; Fortes, C.Q.; Anguera, I.; Athan, E.; Jones, P.; van der Meer, J.T.; Elliott, T.S.; Levine, D.P. and Bayer, A.S. Staphylococcus aureus endocarditis: a consequence of medical progress. (2005) JAMA. 293(24), 3012-3021.
FRANKLIN R. Cockerill; Mathew A. Wikler; Karen Bush; Michael N. Dudley; George M. Eliopoulos; Dwight J. Hardy; David W. Hecht; Janet A. Hindler; Jean B. Patel; Mair Powel; Richard B. Thomson Jr.; John D. Turnide; Melvin P. Weinstein; Barbara L. Zilmmer; Mary Jane Ferraro; Jana M. Zwenson. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-First Informational Supplement. (2011) Clinical and Laboratory Standards Institute.
GROTHE , C.; Belasco A.G.S.; Bittencourt, A.R.C.; Vianna L.A.C.; Sesso, R.C.C.; Barbosa, D.A. Incidence of Bloodstream Infection Among Patients on Hemodialysis by Centrous Venous Catheter. Rev. Latino-Am. Enfermagem Jan-Feb 2010; 18(1): 73-80.
GUZMÁN -BLANCO M, Mejía C, Isturiz R et al. Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in Latin America. Int J Antimicrob Agents. 2009; 34 (4): 304-308
ITO , T.; Ma, X.X.; Takeuchi, F.; Okuma, K.; Yuzawa, H. and Hiramatsu, K. Novel type V staphylococcal cassette chromosome mec driven by a novel cassette chromosome recombinase, ccrC. (2004) Antimicrob Agents Chemother. 48(7), 2637-2651.
KATAYAMA , Y.; Ito, T. and Hiramatsu, K. A new class of genetic element, staphylococcus cassette chromosome mec, encodes methicillin resistance in Staphylococcus aureus. (2000) Antimicrob Agents Chemother. 44(6), 1549-1555.
KONDO , Y.; Ito, T.; Ma, X.X.; Watanabe, S.; Kreiswirth, B.N.; Etienne, J. and Hiramatsu, K. Combination of multiplex PCRs for staphylococcal cassette chromosome mec type assignment: rapid identification system for mec, ccr, and major differences in junkyard regions. (2007) Antimicrob Agents Chemother. 51(1), 264-274.
LINA G, et al. Involvement of Panton-Valentine leukocidin- producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis, 29: 1128 – 1132, 1999.
LINDSAY , J. A.; Holden, M. T. Staphylococcus aureus: superbug, super genome? Trends Microbiol, 12(8), 378-385, 2004.
LIU C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicilin-Resistant Staphylococcus aureus infections in adults and children. Clinical Infectious Diseases 2011; 52: 1-38.
LO, W.T. and Wang, C.C. Panton-Valentine leucocidin in the pathogenesis of community-associated methicillin-resistant Staphylococcus aureus infection. (2011) Pediatr Neonatol. 52(2), 59-65.
LU, P. L. et al. Risk factors and molecular analysis of community methicillin-resistant Staphylococcus aureus carriage. J Clin Microbiol, 43(1), 132-139, 2005.
N.Gardella ; S.Murzicato; S. Di Gregorio; A. Cuirolo; J.Desse; F. Crudo; G.Gutking; M. Mollerach. Prevalence and Characterization of methicilin- resistant Sthaphylococcus aureus among healthy children in city of Argentina. Infection, Genetics and Evolution 11 (2011) 1066-1071
OKUMA . K. et al. Dissemination of new methicillinresistant Staphylococcus aureus clones in the community. J Clin Microbiol, 40: 4289 – 4294, 2002.
OLIVEIRA , D.C.; Tomasz, A. and de Lencastre, H. The evolution of pandemic clones of methicillinresistant Staphylococcus aureus: identification of two ancestral genetic backgrounds and the associated mec elements. (2001) Microb Drug Resist. 7(4), 349-361.
Oliveira , G.A.; Faria, J.B.; Levy, C.E. and Mamizuka, E.M. Characterization of the Brazilian endemic clone of methicillin-resistant Staphylococcus aureus (MRSA) from hospitals throughout Brazil. (2001) Braz J Infect Dis. 5(4), 163-170.
OTTO , M. A MRSA-terious enemy among us: end of the PVL controversy? (2011) Nat Med. 17(2), 169-170.
RAMOS , R.L.; Teixeira, L.A.; Ormonde, L.R.; Siqueira, P.L.; Santos, M.S.; Marangoni, D. and Figueiredo, A.M. Emergence of mupirocin resistance in multiresistant Staphylococcus aureus clinical isolates belonging to Brazilian epidemic clone III::B:A. (1999) J Med Microbiol. 48(3), 303-307.
RIZEK , C.F.; Matte, M.H.; Dropa, M.; Mamizuka, E.M.; de Almeida, L.M.; Lincopan, N.; Matte, G.R. and Germano, P.M. Identification of Staphylococcus aureus carrying the mecA gene in ready-to-eat food products sold in Brazil. (2011) Foodborne Pathog Dis. 8(4), 561-563.
ROBINSON , D.A. and Enright, M.C. Multilocus sequence typing and the evolution of methicillin-resistant Staphylococcus aureus. (2004) Clin Microbiol Infect. 10(2), 92-97.
RODRIGUEZ -NORIEGA , E.; Seas, C.; Guzman-.Blanco, M.; Mejia, C.; Alvarez, C.; Bavestrello, L.; Zurita, J.; Labarca, J.; Luna, C.M.; Salles, M.J. and Gotuzzo, E. Evolution of methicillin-resistant Staphylococcus aureus clones in Latin America. (2010) Int J Infect Dis. 14(7), e560-566.
ROZENBAUM , R.; Sampaio, M.G.; Batista, G.S.; Garibaldi, A.M.; Terra, G.M.; Souza, M.J.; Vieira, E.N.; Silva-Carvalho, M.C.; Teixeira, L.A. and Figueiredo, A.M. The first report in Brazil of severe infection caused by community-acquired methicillinresistant Staphylococcus aureus (CA-MRSA). (2009) Braz J Med Biol Res. 42(8), 756-760.
ROZENBAUM , R.; Silva-Carvalho, M.C.; Souza, R.R.; Melo, M.C.; Gobbi, C.N.; Coelho, L.R.; Ferreira, R.L.; Ferreira-Carvalho, B.T.; Schuenck, A.L.; Neves, F.M.; Silva, L.R. and Figueiredo, A.M. Molecular characterization of methicillin-resistant Staphylococcus aureus disseminated in a home care system. (2006) Infect Control Hosp Epidemiol. 27(10), 1041-1050.
SADER , H.S.; Pignatari, A.C.; Hollis, R.J. and Jones, R.N. Evaluation of interhospital spread of methicillin-resistant Staphylococcus aureus in Sao Paulo, Brazil, using pulsed-field gel electrophoresis of chromosomal DNA. (1994) Infect Control Hosp Epidemiol. 15(5), 320-323.
SHORE , A.C.; Deasy, E.C.; Slickers, P.; Brennan, G.; O’Connell, B.; Monecke, S.; Ehricht, R. and Coleman, D.C. Detection of Staphylococcal Cassette Chromosome mec Type XI Carrying Highly Divergent mecA, mecI, mecR1, blaZ, and ccr Genes in Human Clinical Isolates of Clonal Complex 130 Methicillin-Resistant Staphylococcus aureus. (2011) Antimicrob Agents Chemother. 55(8), 3765-3773.
SOARES , M.J.; Teixeira, L.A.; Nunes, M.R.; da Silva Carvalho, M.C.; Ferreira-Carvalho, B.T. and Figueiredo, A.M. Analysis of different molecular methods for typing methicillin-resistant Staphylococcus aureus isolates belonging to the Brazilian epidemic clone. (2001) J Med Microbiol. 50(8), 732-742.
SOUZA de A. M.; Lencastre de H. Bridges from hospitals to the laboratory: genectic portraits of methicilinresistent Sthaphylococcus aureus clones. FEMS Immunology and Medical Microbiology 40 (2004) 101-111.
TENOVER , F.C.; Arbeit, R.D.; Goering, R.V.; Mickelsen, P.A.; Murray, B.E.; Persing, D.H. and Swaminathan, B. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. (1995) J Clin Microbiol. 33(9), 2233-2239.
ZHANG , K.; McClure, J.A.; Elsayed, S. and Conly, J.M. Novel staphylococcal cassette chromosome mec type, tentatively designated type VIII, harboring class A mec and type 4 ccr gene complexes in a Canadian epidemic strain of methicillin-resistant Staphylococcus aureus. (2009) Antimicrob Agents Chemother. 53(2), 531-540.
CARVALHO, A.M.P. e GIL-PÉREZ, D. Formação de professores de ciências: tendências e inovações. 3. ed. São
CACHAPUZ, A., Gil-Perez, D., Carvalho, A.M.P., Praia, J. e Vilches, A . A Necessária Renovação do Ensino das Ciências. São Paulo, Editora Cortez, 2005.
FOUREZ, G. A. Crise no ensino de ciências? Investigações em Ensino de Ciências, v.8(2),2003.Em http:// www.if.ufrgs.br/ienci/artigos/Artigo_ID99/v8_n2_ a2003.pdf.
GIORDAN, A. e DE VECHI, G. As origens do saber das concepções dos aprendentes aos conceitos científicos. Porto Alegre: Artes Médicas, 1996.
MITRE et al., 2008.
