Etiologia e patogênese de infecções de corrente sangüínea associada ao uso de cateter vascular central (CVC) de longa duração em pacientes submetidos á cirurgia gastrointestinal

Abstract

The central vascular catheter (CVC) is the main factor of bloodstream infections. The aims of this study were to determine the prevalence of CVC usage, etiology and pathogenesis of those infections in eighty patients submitted to gastrointestinal surgery in use of long-term vascular access at HC-UFU. Prevalence inquiries were done of CVC usage at the hospital and cultures of the nostril, site of insertion, tip and hub of the catheter, besides hemoculture on those sepse suspicious. In the inquiry, it was noticed that 15,4 % of patients were CVC users, from which 60,4% were intern in non-critical unities. From eighty patients investigated, it was verified an average time of 10,7 ± 4,0 days/ CVC. The incidence of assimptomatic infection was of 12,5/ 1000 catheter days and to the infection associated to CVC of 3,1/1000 catheter days. The colonization rates of sites of insertion, cannon and tip of catheter were 13,8%, 8,9% and 13,3%, respectively. The Coagulase-negative staphylococci were most isolated from the nostril (75%), site of insertion (45,4%) and hub of the catheter (75%). The gram- negative bacilli (50%) followed by S. aureus (25%), were the most isolated from catheter tip. Detected three cases of bacteremia associated to CVC usage (3,8%) with S. aureus, responsable for two of the episodes of infection and K. pneumoniae for the third. There was no association of skin colonization and of the catheter hub in these patients, but the S. aureus was recovered from the patients nostril who had infection by this pathogenous. One suggests a higher concern about preventive actions and control of these infections, considering the frequency of CVC usage at the hospital with about 60% of these patients in non-critical unities.