Resistência bacteriana em reservatório do semiárido brasileiro: caracterização, ação para vigilância ambiental, prevenção e educação em saúde

Abstract

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 Traíras 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.