Perfil de susceptibilidade aos antimicrobianos de escherichia coli e Klebsiella pneumoniae isoladas em amostras de alface (Lactuca sativa) e água do vale de Infulene, cidade da Matola

Abstract

Pathogenic and antibiotic-resistant strains of Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) have been isolated from water and vegetable samples including lettuce and associated with human infections. Surveillance studies of antimicrobial resistance in water and food are scarce in Mozambique, making it difficult to control the emergence of resistant strains and provide guidance on the treatment of infections. The study aimed to evaluate the antimicrobial susceptibility profile of E. coli and K. pneumoniae isolated in lettuce (Lactuca sativa) and water samples from the Infulene Valley, Matola City. This was a descriptive cross-sectional study that consisted of collecting a total of 153 samples, of which 99 (64.7%) were lettuce and 54 (35.3%) were water samples in the Infulene Valley, between May and November 2023. The identification of E. coli and K. pneumoniae isolates was performed through biochemical tests (MacConkey agar and Simmons Citrate agar), chromogenic media specific for E. coli and Klebsiella spp. and the Analytical Profile Index 20E (API 20E) kit. The antimicrobial susceptibility test was performed including 13 antibiotics, namely: ampicillin, amoxicillin-clavulanic acid, ceftriaxone, ceftazidime, cefepime, amikacin, gentamicin, tetracycline, trimethoprim-sulfamethoxazole, aztreonam, ciprofloxacin, meropenem and imipenem, using the Kirby-Bauer disk diffusion method, following the guidelines of the Clinical and Laboratory Standards Institute (CLSI, 2020). Of the total of 153 samples collected, we identified 33 (22%) E. coli isolates (13 in lettuce and 20 in water) and 30 (20%) K. pneumoniae isolates (15 in lettuce and 15 in water). The E. coli and K. pneumoniae isolates obtained from water and lettuce samples showed high frequencies of resistance to most of the antibiotics tested, such as ampicillin, amoxicillin-clavulanic acid, ceftriaxone, ceftazidime, cefepime, amikacin, gentamicin, tetracycline, sulfamethoxazole-trimethoprim, aztreonam and ciprofloxacin, ranging from 27% to 79% in E. coli isolates and 30% to 100% in K. pneumoniae isolates. Carbapenem antibiotics were the most effective, with both meropenem and imipenem showing sensitivity in 100% of E. coli isolates and in 90% of K. pneumoniae isolates, and these are considered reserve antibiotics for the treatment of multidrug-resistant infections. The frequency of multidrug-resistant E. coli isolates in water samples was 20/20 (100%) and in lettuce samples was 8/13 (62%), while the frequency of multidrug-resistant K. VIpneumoniae isolates in water samples was 14/15 (93%) and in lettuce samples was 9/15 (60%). The presence of resistant E. coli and K. pneumoniae strains in lettuce and water samples in the Infulene Valley poses a risk to public health, making it essential to control sources of contamination, strengthen hygiene rules in lettuce preparation and continue monitoring antimicrobial resistance(TRADUÇÃO NOSSA)