Resistência à linezolida em enterococos resistentes à vancomicina isolados no Brasil

Abstract

The development of antimicrobial resistance in bacteria is a natural biological phenomenon that has been accentuated since the introduction of these drugs in human and veterinary medicine and, also, by their indiscriminate wholesale use as growth promotersin food-producing animals. This research aims to investigate the emergence of oxazolidinone linezolid resistance in enterococci strains resistant to the glycopeptide vancomycin (LVRE, Linezolid-Resistant Vancomycin-Resistant Enterococci) and to analyze the epidemiology of these multidrug-resistant strains in Brazil. The search for articles was performed using the PubMed platform (https://pubmed.ncbi.nlm.nih.gov). Studies reporting vancomycin-resistant enterococci (VRE) strains in Brazil date from 2001, with reference to the first VRE case in 1996, and they report vancomycin resistance only in Enterococcus faecalis and Enterococcus faecium. Reports of VLRE strains were found to be scarce in the country and were recorded, despite the previous increasing emergence of VRE, only in 2014 and 2016 in clinical strains of E. faecalis (ST525 and ST526) and E. faecium (ST412 and ST987) of human origin in the state of SP. Based on the data published, E. faecalis ST525 and ST526 have been recorded up until now only in healthcare settings in Brazil, in the southeast and northeast regions. On the other hand, the circulation of E. faecium ST412 is widely distributed both in Brazil and in other countries, especially in hospital environments. ST987 was initially identified in Brazil and there are still few records of this new lineage in the world; however, ST987 is genetically related to the ST316 and ST78 lineages, which are responsible for hospital infection outbreaks in China. Given this context, it is worth mentioning the need for microbiological monitoring and preventive measures to reduce the VRE spread in hospitals, livestock and in the environment, which would consequently delay the emergence of LVRE strains.