Hemoculturas positivas de pacientes atendidos em um hospital escola

Abstract

Nosocomial infections are a serious public health problem. In recent years, bloodstream infections (BSI) has increased significantly in hospitals, accounting for high morbidity and mortality rates. These, mostly are caused by bacteria, which are detected by performing blood cultures. Currently, due to the frequency and severity of BSI in the hospital environment, it is necessary to evaluate the epidemiological importance data, improving the control and prevention of these infections. Thus, this study aimed to analyze the microorganisms related to BSI from patients admitted to the University Hospital of Santa Maria (HUSM) in the one-year period (2012-2013). We analyzed the epidemiological profile and sensitivity of positive blood cultures of patients admitted at HUSM from April 2012 to March 2013. During the study period, 1080 samples were positive, 69.3% caused by gram-positive organisms (GP), 22.9% by Gram-negative (GN) and 7.9% by fungus. The most common organism was Staphylococcus epidermidis (24%), followed by Staphylococcus hominis (6.8%), Staphylococcus haemolyticus (6.8%) and Pseudmonas aeruginosa (6%). The isolates predominated in male patients (50.6%) and aged between 0-20 years, and the Pediatric/Neonatal Intensive Care Unit was the sector with the highest number of insulation, 24.3% (10.3%/14%). The evaluation of the sensitivity profile showed 100% sensitivity daptomycin, linezolid, tigecycline and vancomycin front of GP microorganisms, and a rate of 42.31% of Staphylococcus were characterized phenotypically as coagulase negative Staphylococcus resistant to methicillin (MRSCoN). Already, between the GN, all microorganisms in study showed 100% of resistance to ampicillin, and Pseudomonas aeruginosa 100% of resistance to cephalothin and cefoxitin, and 1.57% of these isolates showed ESBL mechanism resistance. Impact assessment studies of BSI have significant impact in reducing mortality, especially in patients with weakened immune system, since that provide an immediate start of effective empirical antimicrobial therapy, also decreasing hospital costs. Through this study it was observed that there was a predominance of GP bacteria, and approximately 50% of the isolates were caused by Staphylococcus spp. and 42.31% of strains were resistant to methicillin. This fact should be reconsidered when the empirical antibiotic therapy institution, especially in patients admitted to critical care units. ICS impact assessment studies have significant impact on mortality, especially in patients with weakened immune system, since provide immediate onset of effective empiric antibiotic therapy. These infections should be investigated along the Hospital Infection Control Commission for further steps to be taken, reducing the incidence of ICS, hospital costs and also mortality rates.