Colonization profile and microbiological resistance in Intensive Care Unit (ICU) patients in the city of Anápolis – GO
DOI:
https://doi.org/10.33448/rsd-v10i16.23853Keywords:
Colonization; Intensive care unit; Multidrug-resistant microorganism.Abstract
One of the biggest global health concerns today is the microbial resistance to antibiotics, which contribute to the increase in the mortality rate, the stay in a health institution and favor the colonization process. Thus, colonization is conceptualized as the presence of microorganisms in the human microbiota (intestine, mouth, nose and skin) that do not cause disease or symptoms and can trigger the most varied resistance mechanisms, whether intrinsic or extrinsic. Some of these microorganisms are indispensable for the proper functioning of the human body, however the imbalance of this microbiota can result in complications such as infections. The purpose of this study was to understand the microbiological profile of multidrug-resistant microorganisms in the colonization of patients admitted to Intensive Care Units (ICU) in a private medium-sized and tertiary-level private hospital in the city of Anápolis (GO) from 2017 to 2019, identifying how and when colonizations by such microorganisms occurred. This study was a documentary, retrospective, descriptive and cross-sectional research and the data collection was carried out after appreciation and favorable opinion from the Research Ethics Committee of UniEVANGÉLICA via Plataforma Brasil. As a result, a colonization rate of 6% of the studied sample was observed, 67% of which had Klebsiella sp. Several factors were identified that contribute to the development of colonization and bacterial resistance, including the prevalence of the elderly (74.28%), use of invasive devices (100%), antibiotic use longer than 7 days (42.4 %) and length of stay greater than 48 hours (95.17%). It was concluded, then, that the patients in the present study were submitted to risk conditions, as portrayed in the studied literature, for colonization and bacterial resistance. In addition, the most prevalent bacteria in the ICU studied was Klebsiella sp, as expected according to the studies carried out.
References
Arabancia F. et al (2000). Antimicrobial treatment failures in patients with community-acquired pneumonia: causes and prognostic implications. American Journal Of Respiratory And Critical Care Medicine, 162 (1), 154-60.
Araújo, P.L. et al (2018). Prevalence of health assistance infection in patients hospitalized in intensive therapy unit. Revista eletrônica trimestral de enfermaría, (52), 291-303.
Aycan, I.O. et al (2015). Colonização bacteriana por aumento da carga de trabalho da equipe de enfermagem em unidade de terapia intensive. Revista Brasileira deAnestesiologia, 65 (3), 180-185.
Dani, A. (2014). Colonization ad infection. Central European Journal Of Urology, 67, 86-87.
Figueiredo, E.A.P. et al (2007). Pseudomonas aeruginosa: freqüência de resistência a múltiplos fármacos e resistência cruzada entre antimicrobianos no Recife/PE. Revista Brasileira de Terapia intensiva, 19 (4), 421-427.
Francarolli I.F.L.; Oliveira A.S. & Marziale M.H.P. (2017). Colonização bacteriana e resistência antimicrobiana em trabalhadores de saúde: revisão integrativa. Acta Paulista de Enfermagem, 30 (6), 651-657.
Furuno, J.P. et al (2004). Prediction rules to identify patients with methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci upon hospital admission. American Journal of Infection Control, 32 (8), 436-440.
Grinbaum, R.S. et al (2013). Infecção ou colonização por micro-organismos resistentes: identificação de preditores. Acta Paulista de Enfermagem, 26 (2), 185-191.
Johnson, J. K. et al (2017). Carbapenem MICs in Escherichia coli and Klebsiella species producing extended-spectrum beta-lactamase in critical care patients from 2001 to 2009. American Society for Microbiology, 61 (4), 1-9.
Joo, E.J. et al (2011). Clinical preditos of Pseudomonas aeruginosa bacteremia among Gram-negative bacterial infections in non-neutropenic patients with solid tumor. Journal of Infection, 63 (3), 207-214.
Kabak, E. et al (2019). The utility of endotracheal aspirate bacteriology in identifying mechanically ventilated patients at risk for ventilator associated pneumonia: a single-center prospective observational study. BMC Infectious Diseases, 19 (756), 1-13.
Kantele, A. et al (2017). Patients hospitalized abroad as importers of multiresistant bacteria – a cross-sectional study. Clinical Microbiology and Infection, 23, 1-8.
Kim, Y.J. et al (2012). Carbapenem-resistant Acinetobacter baumannii: diversity of resistence mechanisms and risk factors for infection. Epidemiology and Infection, 140 (1), 137-145.
Lee, C.E.; Zembower T.R. & Fotis M.A. (2000). The Incidence of Antimicrobial Allergies in Hospitalized Patients Implications Regarding Prescribing Patterns and Emerging Bacterial Resistance. Archives of Internal Medicine, 160 (18), 2819-2822
Lee, S.O. et al (2004). Risk Factors for Acquisition of Imipenem-Resistant Acinetobacter baumannii: A Case-Control Study. Antimicrobial Agents and Chemotherapy, 48 (1), 224-228.
Lim J.U.; Hong S.W.& Ko J.H. (2019). Efficacy of inhaled ciprofloxacin agents for the treatment of bronchiectasis: a systematic review and meta-analysis of randomized controlled trials. Therapeutic Advances in Respiratory Disease, 13, 1-11.
Moraes, G.M. et al (2013). Infecção ou colonização por micro-organismos resistentes: identificação de preditores. Acta Paulista de Enfermagem, 26 (2), 185-191.
Mota, F.S. et al (2018). Perfil e prevalência de resistência aos antimicrobianos de bactérias Gram-negativas isoladas de pacientes de uma unidade de terapia intensiva. Revista Brasileira de Análises Clínicas, 50 (3), 270-277.
Neves, F.C. et al (2016). Clinical and microbiological characteristics of OXA-23- and OXA-143-producing Acinetobacter baumannii in ICU patients at a teaching hospital, Brazil. Brazilian Journal of Infectious Diseases, 20 (6) 556-563.
Oliveira, A.C. et al (2012a). Colonization by resistant micro-organism and infection related to health care. Acta Paulista de Enfermagem. 25 (2), 183-189.
Oliveira, A.C. et al (2017b). Perfil dos microrganismos associados à colonização e infecção em Terapia Intensiva. Revista de Epidemiologia e Controle de Infecção, 7 (2), 101-106.
Oliveira, A.C. et al (2010c). Resistência bacteriana e mortalidade em um centro de terapia intensiva. Latino Americano Enfermagem, 18 (6), 1-10.
Reis, A.C.C. et al (2016). Ciprofloxacin resistance pattern among bacteria isolated from patients with community-acquired urinary tract infection. Revista Do Instituto de Medicina Tropical de São Paulo, 58 (53).
Rodrigues, T.S. et al (2018). Resistência bacteriana à antibióticos na Unidade de Terapia Intensiva: Revisão Integrativa. Revista Prevenção de Infecção e Saúde, 4 (7350) 1-17.
Safdar N. & Maki D.G. 2002. The commonality of risk factors for nosocomial colonization and infection with antimicrobial-resistant S. aureus, Enterococcus, Gram-Negative Bacilli, Clostridium difficile, and Candida. Annals of Internal Medicine, 136, 834-44.
Scarcella A.C.A.; Scarcella A.S.A. & Beretta L.R.Z. (2017). Infecção relacionada à assistência à saúde associada a Acinetobacter baumannii: revisão de literatura. Revista Brasileira de Análises Clínicas, 49 (1), 18-21.
Schwaber, M.J. et al (2008). Predictors of Carbapenem-Resistant Klebsiella pneumoniae Acquisition among Hospitalized Adults and Effect of Acquisition on Mortality. Antimicrobial Agents and Chemotherapy, 52 (3), 1028-1033.
Silva C.D.R. & Silva J.M. (2015). Strategies for appropriate antibiotic use in intensive care unit. Einstein, 13 (3), 448 – 453.
Sousa A.B.A. & Ramalho F.L. (2020). Prevalence of nosocomial infections caused by Klebsiella pneumonie carbapenemase (KPC) in hospitalized patients. Brazilian Journal of health review, 3 (2), 1915-1932.
Tacconelli, E. et al (2004). Preventing the Influx of Vancomycin-Resistant Enterococci into Health Care Institutions, by Use of a Simple Validated Prediction Rule. Clinical Infectious Diseases, 39, (7), 964-970
Tamma, P.D. et al (2019). Association of 30-Day MortalityWith Oral Step-Down vs Continued Intravenous Therapy in Patients Hospitalized With Enterobacteriaceae Bacteremia. JAMA Internal Medicine, 179, (3), 316-323.
Veloso, J.O. et al (2019). Methicilin-resistant and vancomycin-intermediate Staphylococcus aureus colonizing patients and intensive care unit environment: virulent a profile and genetic variability. Journal of Pathology, Microbiology and Immunology, 127, 717-726.
Vieira, A.M. et al. Characteristics os deaths oh hospitalized patients in Intensive Care Unit of a tertiary hospital (2019). Journal of health e biological sciences, 7 (1), 26-31.
WHO – World Health Organization (2014). Antimicrobial resistance: global report on surveillance.
WHO – World Health Organization (2017). Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics
WHO – World Health Organization (2018). WHO Report on Surveillance of Antibiotic Consumption.
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Copyright (c) 2021 Ana Carolina Guterres Gabriel; Déborah Helena Pereira Pinheiro; Luana Mendonça Siqueira Fernandes; Mariana Malagoni Wind; Verônica Reis Ferreira; Maria Sônia Pereira
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