Hospital infections in the Intensive Care Unit: An integrative review
DOI:
https://doi.org/10.33448/rsd-v11i10.32591Keywords:
Hospital infection; Intensive care unit; Critical care.Abstract
To describe the most prevalent microorganisms in the Intensive Care Unit and the main ‘ factors for patients who need this type of support. This is an integrative literature review, using the Pubmed, Scielo and Virtual Health Library (BVS) databases. The controlled descriptors “hospital infection”, “ICU” and “critical care” were used. Using the Boolean operator “AND”. In the period from 2017 to 2021. As inclusion criteria: primary studies and full article in full that responded to the objective, as exclusion criteria: monographs, case studies; periodicals; incomplete texts. Eight articles were selected at the end of the analysis for the study. It was pointed out that multidrug-resistant gram-negative bacilli were the main microorganisms causing infections in ICUs, namely: Acinetobacter baumannii; Pseudomonas aeruginosa and Enterobacter and Klebsiella. Among the most frequent gram positives are: Staphylococcus epider; Pneumoal Staphylococcus and Enterococcus spp. Among the selected studies, it is observed that the risk factors commonly reported were long-term antimicrobial therapy, length of hospital stay and invasive procedures, age and sex. The most prevalent microorganisms were gram negative bacilli that inhabit the patient's natural microbiota, which over the years have acquired multi-resistance to the antibiotics most used in clinical practice. Such infections are related to the health services provided. Measures such as hand hygiene and controlled use of antibiotics are still the most effective means of controlling HAIs in the ICU.
References
Agência nacional de vigilância sanitária (2017). Boletim segurança do paciente e qualidade em Serviços de Saúde nº17: Avaliação dos indicadores de IRAS e Resistência microbiana. Brasília, DF. https://www.gov.br/anvisa/pt.
Araújo, B. T., et al. (2017) Políticas para controle de Infecções Relacionadas à Assistência à Saúde (IRAS) no Brasil. https://bvsms.saude.gov.br/bvs/periodicos/ccs_artigos/v28_3_politica_controle_%20infeccao.pdf.
Araújo, P. L., et al. (2018). Prevalencia de la infección relacionada con la asistencia a la salud en pacientes hospitalizados en unidad de cuidados intensivos. Enfermería Global. 17(52), 278-315. https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1695-61412018000400278>
Ardisson, L., Miranda, M., & Teixeira, C. (2021) Panorama epidemiológico das infecções relacionadas à assistência à saúde. Cadernos Camilliani. 16(4) 1624-1639. http://www.saocamilo-es.br/revista/index.php/cadernoscamilliani/article/view/354>.
Bonnet, V., et al. (2019). Influence of bacterial resistance on mortality in intensive care units: a registry study from 2000 to 2013 (IICU Study). Journal of Hospital Infection. 102(3) 317-324. https://www.sciencedirect.com/science/article/abs/pii/S0195670119300131>
,
Brasil. (2020) Presidência da República. Resolução n° 2.271. Define as unidades de terapia intensiva e unidades de cuidado intermediário conforme sua complexidade. https://www.in.gov.br/web/dou/-/resolucao-n-2.271-de-14-de-fevereiro-de-2020-253606068.
Calixto, J. B., et al. (2020). Perfil da infecção hospitalar em unidades de terapia intensiva: revisão integrativa. Revista Interdisciplinar Encontro das Ciências, 3(2). https://riec.univs.edu.br/index.php/riec/article/view/142>
Carioca, G. (2019). Perfil epidemiológico de infecções relacionadas à assistência à saúde na UTI geral de um hospital filantrópico brasileiro. Trabalho de Conclusão de Curso (Bacharelado em Farmácia) – Faculdade Guairacá, htt://200.150.122.211:8080/jspui/handle/23102004/131
Carvalho, J. J. V., et al. (2021). Bactérias multirresistentes e seus impactos na saúde pública: Uma responsabilidade social. Research, Society and Development. 10(6) 58810616303-e58810616303. https://rsdjournal.org/index.php/rsd/article/view/16303.>
Euzébio, D. M., et al. (2021). Perfil epidemiológico das infecções relacionadas à assistência à saúde em Unidade de Terapia Intensiva. Research, Society and Development 10(17), 2101724926-e2101724926. https://www.redalyc.org/journal/5704/570464292009/570464292009.pdf.
Gupta, R., et al. (2017) Epidemiology of multidrug-resistant Gram-negative pathogens isolated from ventilator-associated pneumonia in ICU patients. Journal of global antimicrobial resistance. 9, 47-50. https://www.sciencedirect.com/science/article/pii/S2213716517300322.
Hespanhol, L. A. B., et al. (2019). Infecção relacionada à Assistência à Saúde em Unidade de Terapia Intensiva Adulto. Enfermería Global. 18(1) 215-254. https://revistas.um.es/eglobal/article/view/eglobal.18.1.296481.
Laxminarayan, R., et al. (2013). Antibiotic resistance: the need for global solutions.The Lancet infectious diseases. 13(12), 1057-1098. https://www.sciencedirect.com/science/article/abs/pii/S1473309913703189>
Mascarenhas, M. N. J., et al. (2018) Incidência de infecções relacionadas à assistência à saúde na UTI adulto em quatro hospitais de Salvador-BA. 25f.Trabalho de Conclusão de Curso (Bacharelado em Enfermagem) - Universidade Católica de Salvador, Salvador. http://ri.ucsal.br:8080/jspui/handle/prefix/675.
Mendonça, D. L., Ribeiro, E. V., & Silva, J. T. N. (2019) Prevalência e perfil de sensibilidade dos microrganismos isolados em aspirado traqueal de pacientes com pneumonia associada à ventilação mecânica em unidade de terapia intensiva. CEP. 36301, 182. file:///C:/Users/Canto/Downloads/845-Corpo%20do%20Manuscrito-3668-2-10-20191217-1.pdf >
Mota, F. S., Oliveira, H. A., & Souto, R. C. F. (2018). Perfil e prevalência de resistência aos antimicrobianos de bactérias Gram-negativas isoladas de pacientes de uma unidade de terapia intensiva. RBAC. 50(3), 270-277. http://www.rbac.org.br/wp-content/uploads/2019/01/RBAC-vol-50-3-2018-ref-740-final.pdf >
Rello, J., et al. (2019). Perceived differences between intensivists and infectious diseases consultants facing antimicrobial resistance: a global cross-sectional survey. European Journal of Clinical Microbiology & Infectious Diseases. 38(7), 1235-1240. https://link.springer.com/article/10.1007/s10096-019-03530-1#Abs1>
Rodrigues, T. S., et al. (2018). Resistência bacteriana a antibióticos na Unidade de Terapia Intensiva: revisão integrativa. Revista Prevenção de Infecção e Saúde. 4. https://revistas.ufpi.br/index.php/nupcis/article/view/7350 >
Sabino, S. S., et al. (2018). Infecções hospitalares por micro-organismos resistentes aos antimicrobianos em pacientes internados na unidade de terapia intensiva de adultos em um hospital terciário de Minas Gerais: incidência, etiologia, fatores de risco, evolução e custos. 73f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Uberlândia, Uberlândia. https://repositorio.ufu.br/bitstream/123456789/21350/1/InfeccoesHospitalaresMicroorganismos.pdf. < https://repositorio.ufu.br/handle/123456789/21350 >
Saied, W. I., et al. (2019). A comparison of the mortality risk associated with ventilator-acquired bacterial pneumonia and nonventilator ICU-acquired bacterial pneumonia. Critical Care Medicine. 47(3), 345-352.
Silva, T. M. F., et al. (2021). Infecções hospitalares associadas à bacilos gram-negativos não fermentadores em unidade de terapia intensiva: revisão narrativa. Revista Eletrônica Acervo Saúde. 13(3), e6685-e6685. https://doi.org/10.25248/reas.e6685.2021 >
Silva, L. S., et al. (2019). Perfil das infecções relacionadas à assistência à saúde em um centro de terapia intensiva de Minas Gerais. Revista de Epidemiologia e Controle de Infecção. 9(4). https://doi.org/10.17058/.v9i4.12370 >
Siwakoti, S., et al. (2018). Incidence and outcomes of multidrug-resistant gram-negative bacteria infections in intensive care unit from Nepal-a prospective cohort study. Antimicrobial Resistance & Infection Control. 7(1), 1-8. https://doi.org/10.1186/s13756-018-0404-3>
Tomaszewski, D., Rybicki, Z., & Duszyńska, W. (2019). The Polish Prevalence of Infection in Intensive Care (PPIC): A one-day point prevalence multicenter study. Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University. 28(7), 907-912. < 10.17219/acem/94147.PMID: 30986000. >
Walaszek, M., et al. (2018). Epidemiology of healthcare-associated infections in Polish intensive care. A multicenter study based on active surveillance. Biomedical Papers of the Medical Faculty of Palacky University in Olomouc. 162(3). < 10.5507/bp.2018.006. Epub 2018 Mar 1. PMID: 29795542.>
Wang, M., et al. (2019). Analysis of multidrug-resistant bacteria in 3223 patients with hospital-acquired infections (HAI) from a tertiary general hospital in China. Bosnian journal of basic medical sciences. 19(1), 86. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6387671/. >
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Copyright (c) 2022 Nadjane da Silva Sena; Carla Adriana Gouveia Costa; Jaqueline Maria Silva dos Santos; Uirassú Tupinambá Silva de Lima; Bruno Edilson Pereira do Nascimento; Daysi da Silva Lins; Emanuelle de Almeida Santos; Thácilla Fernanda Oliveira da Silva; Jaqueline Arantes Diniz Basílio; Elvany de Sena Santos
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