Epidemiologia molecular de Staphylococcus aureus no Brasil: elevada frequência de clones epidêmicos|pandêmicos, CA-MRSA e perspectivas futuras / Molecular epidemiology of Staphylococcus aureus in Brazil: high frequency of international epidemic|pandemic clones, CA-MRSA and perspectives

Suelen Cristina Gomes dos Santos, Lara Nardi Baroni, Maria Rita de Albuquerque Almeida Neta, Tereza Cristina Leal-Balbino, Mariana Andrade-Figueiredo

Abstract


Staphylococcus aureus meticilina-resistente (MRSA) e meticilina-sensível (MSSA) são importantes patógenos nas infecções adquiridas na comunidade e nos hospitais no Brasil e em todo o mundo. O presente estudo tem como objetivo realizar uma revisão da literatura a respeito da epidemiologia molecular e resistência antimicrobiana de S. aureus à meticilina no Brasil e sua importância para Saúde Pública. Embora existam muitos artigos que investiguem a genômica de S. aureus, há relativamente poucos artigos que investigam os MRSA em escala genômica no país. A publicação mais antiga descreve a disseminação inter-hospitalar de um único clone MRSA em oito dos nove hospitais sob vigilância epidemiológica em São Paulo entre 1990 e 1992. Um ano depois, isolados MRSA provenientes de grandes hospitais universitários, presentes em diferentes regiões do Brasil, demonstraram o mesmo padrão de PFGE, indicando que um único clone, o clone epidêmico Brasileiro (BEC/ST239/CC8/SCCmecIII), estava disseminado no Brasil. Desde então, o BEC tem sido altamente prevalente nos hospitais do país, apresentando frequência acima de 50% em relação a todos os S. aureus isolados no Brasil. Embora o clone BEC seja o mais frequente, diversos estudos relatam um aumento expressivo na presença de clones como o USA400 (ST1/CC1/SCCmecIV) e o clone Pediátrico (USA800/ST5/CC5/SCCmecIV) em hospitais do Brasil, além da presença de outros clones como o USA100/New York/Japan (ST5-SCCmecII) e o clone USA1100/Southwest pacific clone (SWP) (ST30-SCCmecIV). Adicionalmente, a prevalência de MRSA em infecções adquiridas na comunidade (CA-MRSA) se encontra em ascensão. São necessários ainda mais estudos para que haja um maior conhecimento a respeito da epidemiologia molecular, virulência e resistência antimicrobiana de S. aureus à meticilina no Brasil, especialmente nas regiões Norte, Nordeste e Centro-Oeste do país, visto que a maioria dos estudos se concentram no eixo sul-sudeste, limitando a análise do perfil de S. aureus no país.

 

 


Keywords


Staphylococcus aureus, MRSA clones, genotyping.

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DOI: https://doi.org/10.34117/bjdv7n4-166

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