Analysis of patient profile and factors related to healthcare-associated infections due to multidrug-resistant bacteria in the ICU of a hospital in Southern Brazil

Authors

DOI:

https://doi.org/10.33448/rsd-v11i16.38127

Keywords:

Multiple antibacterial drug resistance; Healthcare Associated Infection; Delivery of health care; Intensive care unit.

Abstract

Healthcare-related infections are a worldwide concern, as they increase morbidity and mortality of hospitalized patients, especially those in intensive care units. When the etiology of these infections is a multidrug-resistant microorganism, complications in treatment are even greater, and there are limited options for management. Thus, this study analyzed the occurrence of such infections in the intensive care units of the Campos Gerais Regional University Hospital from January 2017 to December 2019 by analyzing the spreadsheets provided by the Center for Hospital Infection Control and subsequent analysis of prevalence, means and medians by Excel software with the aim of profiling the patients most susceptible to contracting these infections and to analyze the microbiological profile of the sample.  As for the epidemiological profile, most cases were registered in men, people over 60 years old, and patients with comorbidities. As for the microbiological profile found, the most prevalent bacteria was Klebsiella pneumoniae, with 34 cases, followed by Staphylococcus aureus, responsible for 33 occurrences. The most frequently observed resistance mechanism was methicillin-resistant Staphylococcus aureus. We conclude that infections caused by multidrug-resistant microorganisms are a concern for professionals who work in hospitals, especially in intensive care units, and that they should pay attention to preventive measures and conscientious use of antimicrobials.

Author Biographies

Celine Iris Meijerink, Universidade Estadual de Ponta Grossa

Acadêmica de Medicina da Universidade Estadual de Ponta Grossa

Felipe Câncio Nascimento, Universidade Estadual de Ponta Grossa

Acadêmico de Medicina da Universidade Estadual de Ponta Grossa

Renato Mandalozzo Tebcherani, Universidade Estadual de Ponta Grossa

Acadêmico de Medicina da Universidade Estadual de Ponta Grossa

Laura Bazzi Longo, Universidade Estadual de Ponta Grossa

Acadêmica de Medicina da Universidade Estadual de Ponta Grossa

Carmen Antônia Sanches Ito, Universidade Estadual de Ponta Grossa

Professora do Departamento de Enfermagem da Universidade Estadual de Ponta Grossa

Larissa Bail, Universidade Estadual de Ponta Grossa

Professora do Departamento de Enfermagem da Universidade Estadual de Ponta Grossa

Maria Dagmar da Rocha Gaspar, Universidade Estadual de Ponta Grossa

Professora do Departamento de Enfermagem da Universidade Estadual de Ponta Grossa

Elisangela Gueiber Montes, Universidade Estadual de Ponta Grossa

Professora do Departamento de Análises Clínicas e Toxicológicas da Universidade Estadual de Ponta Grossa

References

ANVISA (2020). Microbiologia Clínica para o Controle de Infecção Relacionada à Assistência à Saúde (1st ed., Vol. 10, p. 31-33) Anvisa.

Bassetti, M., & Righi, E. (2013). Multidrug-resistant bacteria: what is the threat? Hematology, 2013(1), 428–432. https://doi.org/10.1182/asheducation-2013.1.428

Campion, M., & Scully, G. (2018). Antibiotic Use in the Intensive Care Unit: Optimization and De-Escalation. Journal of Intensive Care Medicine, 33(12), 647–655. https://doi.org/10.1177/0885066618762747

Como interpretar o novo antibiograma - CML. (n.d.). Centro de Medicina Laboratorial. Retrieved November 15, 2022, from https://cmllab.com.br/medico/noticias/como-interpretar-o-novo-antibiograma

Doyle, J., Buising, K., Thursky, K., Worth, L., & Richards, M. (2011). Epidemiology of Infections Acquired in Intensive Care Units. Seminars in Respiratory and Critical Care Medicine, 32(02), 115–138. https://doi.org/10.1055/s-0031-1275525

Fraimow, H. S., & Tsigrelis, C. (2011). Antimicrobial Resistance in the Intensive Care Unit: Mechanisms, Epidemiology, and Management of Specific Resistant Pathogens. Critical Care Clinics, 27(1), 163–205. https://doi.org/10.1016/j.ccc.2010.11.002

Hochman, B., Nahas, F. X., Filho, R. S. de O., & Ferreira, L. M. (2005). Desenhos de pesquisa. Acta Cirúrgica Brasileira, 20(2), 2–9.

https://doi.org/10.1037/met0000082

Infecções Relacionadas à Assistência à Saúde. (n.d.). Saude.curitiba.pr.gov.br. Retrieved November 15, 2022, from https://saude.curitiba.pr.gov.br/vigilancia/epidemiologica/vigilancia-de-a-a-z/12-vigilancia/221-vig.html

Kołpa, M., Wałaszek, M., Gniadek, A., Wolak, Z., & Dobroś, W. (2018). Incidence, Microbiological Profile and Risk Factors of Healthcare-Associated Infections in Intensive Care Units: A 10 Year Observation in a Provincial Hospital in Southern Poland. International Journal of Environmental Research and Public Health, 15(1), 112. https://doi.org/10.3390/ijerph15010112

Litwin, A., Fedorowicz, O., & Duszynska, W. (2020). Characteristics of Microbial Factors of Healthcare-Associated Infections Including Multidrug-Resistant Pathogens and Antibiotic Consumption at the University Intensive Care Unit in Poland in the Years 2011–2018. International Journal of Environmental Research and Public Health, 17(19), 6943. https://doi.org/10.3390/ijerph17196943

Lorenzoni, V. V., Rubert, F. da C., Rampelotto, R. F., & Hörner, R. (2018). Increased antimicrobial resistance in Klebsiella pneumoniae from a University Hospital in Rio Grande do Sul, Brazil. Revista Da Sociedade Brasileira de Medicina Tropical, 51(5), 676–679. https://doi.org/10.1590/0037-8682-0362-2017

Magira, E. E., Islam, S., & Niederman, M. S. (2018). Multi-drug resistant organism infections in a medical ICU: Association to clinical features and impact upon outcome. Medicina Intensiva, 42(4), 225–234. https://doi.org/10.1016/j.medin.2017.07.006

Martín-Loeches, I., Diaz, E., & Vallés, J. (2014). Risks for multidrug-resistant pathogens in the ICU. Current Opinion in Critical Care, 20(5), 516–524. https://doi.org/10.1097/mcc.0000000000000124

Mitharwal, S. M., Yaddanapudi, S., Bhardwaj, N., Gautam, V., Biswal, M., & Yaddanapudi, L. (2016). Intensive care unit-acquired infections in a tertiary care hospital: An epidemiologic survey and influence on patient outcomes. American Journal of Infection Control, 44(7), e113–e117. https://doi.org/10.1016/j.ajic.2016.01.021

Myrianthefs, P. M., Kalafati, M., Samara, I., & Baltopoulos, G. J. (2004). Nosocomial Pneumonia. Critical Care Nursing Quarterly, 27(3), 241–257. https://doi.org/10.1097/00002727-200407000-00005

Petrosillo, N., Granata, G., Boyle, B., Doyle, M. M., Pinchera, B., & Taglietti, F. (2019). Preventing sepsis development in complicated urinary tract infections. Expert Review of Anti-Infective Therapy, 18(1), 47–61. https://doi.org/10.1080/14787210.2020.1700794

Riley, M. M.-S. (2019). The Rising Problem of Multidrug-Resistant Organisms in Intensive Care Units. Critical Care Nurse, 39(4), 48–55. https://doi.org/10.4037/ccn2019773

Solmaz, İ., & Kalın, B. S. (2020). Assessment of antibiotic resistance of infectious agents in patients with pneumonia in tertiary critical care unit and effect on clinical outcomes. International Journal of Clinical Practice. https://doi.org/10.1111/ijcp.13872

Su, L.-H., Chen, I-Ling., Tang, Y.-F., Lee, J.-S., & Liu, J.-W. (2020). Increased financial burdens and lengths of stay in patients with healthcare-associated infections due to multidrug-resistant bacteria in intensive care units: A propensity-matched case-control study. PLOS ONE, 15(5), e0233265. https://doi.org/10.1371/journal.pone.0233265

Trilla, A. (1994). Epidemiology of nosocomial infections in adult intensive care units. Intensive Care Medicine, 20(S3), S1–S4. https://doi.org/10.1007/bf01745243

Weiner-Lastinger, L. M., Abner, S., Edwards, J. R., Kallen, A. J., Karlsson, M., Magill, S. S., Pollock, D., See, I., Soe, M. M., Walters, M. S., & Dudeck, M. A. (2019). Antimicrobial-resistant pathogens associated with adult healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network, 2015–2017. Infection Control & Hospital Epidemiology, 41(1), 1–18. https://doi.org/10.1017/ice.2019.296

Wilcox, M. H., & Dryden, M. (2021). Update on the epidemiology of healthcare-acquired bacterial infections: focus on complicated skin and skin structure infections. Journal of Antimicrobial Chemotherapy, 76(Supplement_4), iv2–iv8. https://doi.org/10.1093/jac/dkab350

Zaragoza, R., Ramírez, P., & López-Pueyo, M. J. (2014). Infección nosocomial en las unidades de cuidados intensivos. Enfermedades Infecciosas Y Microbiología Clínica, 32(5), 320–327. https://doi.org/10.1016/j.eimc.2014.02.006

Published

12/12/2022

How to Cite

MEIJERINK, C. I.; NASCIMENTO, F. C. .; TEBCHERANI, R. M.; LONGO, L. B. .; ITO, C. A. S. .; BAIL, L.; GASPAR, M. D. da R. .; MONTES, E. G. . Analysis of patient profile and factors related to healthcare-associated infections due to multidrug-resistant bacteria in the ICU of a hospital in Southern Brazil. Research, Society and Development, [S. l.], v. 11, n. 16, p. e379111638127, 2022. DOI: 10.33448/rsd-v11i16.38127. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/38127. Acesso em: 14 nov. 2024.

Issue

Section

Health Sciences