Staphylococcus aureus resistentes a meticilina isolados da microbiota vaginal de mulheres com e sem Candidíase vulvovaginal

Abstract

Introduction: Staphylococcus aureus and Candida albicans are frequently isolated concomitantly in the human microbiota, but in cases of vulvovaginal candidiasis, the presence of S. aureus is worrisome. Objectives: To determine the frequency of S. aureus isolated from vaginal contents of women with and without vulvovaginal candidiasis (VVC), and to characterize the virulence and resistance of these microorganisms. Methods: Bacterial samples isolated from vaginal contents and clinical data from 86 patients with and without VVC were studied. The 116 bacterial isolates obtained were submitted to PCR to identify S. aureus (sau gene) and MRSA (mecA gene), and the staphylococcal chromosome cassette mec (SCCmec) was characterized by multiplex PCR. Samples positive for S. aureus were subjected to disk-diffusion method to determine antimicrobial resistance. Staphylococcal enterotoxin A, B, C, D and Toxic Shock Syndrome Toxin 1 (TSST-1) genes were screened by PCR. Results: Ten (8.6%) S. aureus were isolated from 9 patients, one of them a patient with VVC. Of the 10 S. aureus isolates, 9 (90%) were MRSA and 6 of these (66.6%) had SCCmec type I and 3 (33.3%) had SCCmec IV. The enterotoxin A gene (sea gene) was detected in 5 (50%) of S. aureus, in 4 MRSA with SCCmec I and 1 MRSA with SCCmec IV. Conclusions: The study did not confirm the association of vulvovaginal candidiasis with S. aureus vaginal carriage, but it provided important information about S. aureus in the vaginal contents of healthy young women, highlighting the high frequency of MRSA and the high rate of antimicrobial resistance, in addition to the ability to produce enterotoxin A which can aggravate possible staphylococcal infections.