Trânsito de profissionais e pacientes de terapia intensiva entre diferentes hospitais: possível risco de disseminação de micorganismos multirresistentes

Abstract

Spread of multidrug-resistant microorganisms is a worldwide public health problem. Antimicrobial use in hospitals, especially in Intensive Care Units (ICU) induces and selects resistant microorganisms. These are disseminated through colonized health professionals and patients circulating in the areas intra and inter- hospitals. The aim of this study is to identify the frequency with which patients admitted to Intensive Care Units and healthcare professionals, who provide direct care to them, move between different institutions and the indicia of possible causal relationship between the transit and the occurrence of pathogens microorganisms and antimicrobial resistance. Interviews were conducted with health professionals working in hospitals Intensive Care Units in the cities of Uberlândia and Patrocínio. Microbiology databases of the each hospital were also consulted as well as patients medical records. About half of the interviewed health professionals provide assistance in more than one institution and about a quarter also performed activities in different sectors within the same hospital. Three hundred seventy-six (12.32%) patients had undergone transference, but this percentage varies for each hospital (p = 0.0000). In all studied ICUs the bacteria most frequently isolated so far were: Pseudomonas aeruginosa, Staphylococcus aureus, coagulase-negative Staphylococci, Acinetobacter baumannii, Klebsiela pneumoniae, Escherichia coli, Enterobacter cloacae and Enterococcus faecalis. Bacterial resistance to antimicrobials was also similar in the six ICUs. We conclude that patients and mostly health professionals frequently move between different sectors of the same hospital and between other hospitals in the study region. Therefore, the transit may have epidemiological importance, which is suggested by the similarity of microorganisms isolated in hospitals in the present study.