Aspectos epidemiológicos de infecções relacionadas a cateteres vasculares centrais em pacientes cirúrgicos internados no Hospital de Clínicas da Universidade Federal de Uberlândia

Abstract

A prospective observational study to investigated nontunneled central venous catheter over a 24-month(set-2000/nov-2002) period in 179 patients at the Clinicai Surgical II Ward in the Uberlândia Federal University Hospital (HC-UFU) was carrried out. The colonization rate of the catheter tips was of 21,2%. The independent risk factors associated with a colonization of the catheter tip was: colonization in the insertion site of CVC ^200UFC/20cm (p—0,01,OR—2,15), hospital stay >14 days (p=0,04; OR=1,97), catheterization >7 days (p=0,038; OR=1,78). The insert in jugular vein was associated the most serious patients with following independent risk factors: internment >14 days (p=0,03; OR=2,37), catheterization £7days(p=0,01; OR=3,65) and use of >3 invasive devices(p=0,04; OR=1,89). The analysis of regression logistics for CR-BSI detected the following independent risk factors: colonization pericatheter >200 UFC/20cm2 (p<0,01; OR=6,89) and catheter tip with >102UFC (p <0,01; OR=7,95). CoNS was more isolated the skin insertion site (50%) and catheter tip (60%) and Staphylococcus auraus (48%) in the bloodstream followed by CoNS (38%) and BGN (17%). CR-BSI rate caused by S. aureus was 4,9 episodes per 1000 catheter/days. The resistance to the oxacillin was observed in 43,7% strains analysed. Nine patients presented the S. aureus simultaneously in two or three sites (CVC insetion site and/or catheter tip and/or blood) was analyzed by PFGE and Rep-PCR. Nine samples of MRSA belonged to the profile clonal A by PFGE (subclones A1, A2 and A3) and Rep-PCR demonstrated two different clones (A, B). PFGE pattems for MSSA distinguished five types (a,b,c,d and e) and Rep-PCR only three (a,b and c). We can conclude that CR-BSIs caused by policlonal S. aureus had the skin pericateter as source of this microorganism.