Name: Mariana Perin de Medeiros Davariz
Type: MSc dissertation
Publication date: 25/08/2022

Namesort descending Role
Sérvio Túlio Alves Cassini Advisor *

Examining board:

Namesort descending Role
Liliana Cruz Spano External Examiner *
Luiz Claudio Gomes Pimentel External Examiner *
Regina de Pinho Keller Internal Examiner *
Ricardo Pinto Schuenck Co advisor *
Rodrigo de Alvarenga Rosa Co advisor *
Sérvio Túlio Alves Cassini Advisor *

Summary: Since their introduction into medicine, antibiotics (ATB) are the most important options
for treating infectious diseases. However, identifications of antibiotic-resistant
pathogens have been more frequent among human and animal populations in response
to the selective pressure exerted by the excessive use of ATB. In the scientific
community, hospital effluents have been drawing more attention as an important
source of bacterial resistance to antibiotics (ARB) and their associated genes (ARG).
Without treatment, ARB and ARG from hospital effluents can disperse into the
environment. Escherichia coli (E.coli) is one of the main indicators of water quality
referenced in the legislation, evidencing recent contamination by sanitary sewage. The
analysis of antibiotic resistance in E.coli can represent a significant approximation of the
general effects of ARB in sewage and its possible environmental spread. The present
study characterized effluent samples from four hospitals in the Metropolitan Region of
Vitória - ES in december 2020 and kanuary 2021 and analyzed the susceptibility profile
of Escherichia coli isolates against the action of twelve antibiotics. In the physicalchemical analysis of hospital effluents, in general, the values obtained are within those
found in the literature. Evidence of contamination by effluents was found in a lake
belonging to a hospital unit. Most of the resistances found in the samples were related
to AMP (35%), TET, (33%), CIP (23%), AMC (19%), SUT (16%), CLO (12%), CFE and CTX
(9% each), PPT, ATM and GEN (8% each) and IPM (1%). Resistance to MER was not found
in any of the isolates, only one sample characterized as resistant increasing to the
exposure of the HUCAM 1 point. Of the isolates, 18% of them were resistant to the
cephalosporins tested, being observed at the entrance and exit of the ETE of the HJSN,
in the Lagoa do HUCAM and at one of the HEAC points. Such monitoring of ATB
resistance levels in bacteria such as Escherichia coli in effluents can be used as an early
warning system for changes in resistance patterns in the human and animal population.
However, the potential human and nature risk in relation to the discharge of hospital
effluents with BRA`s and GRA`s are still uncertain. It is necessary to standardize reporting
and monitoring requirements like so many other water quality parameters, especially in
Brazil, to allow the construction of a database that is essential for evidence-based health

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