Epidemiologia das infecções de corrente sanguínea de um CTI de adultos mineiro

Abstract

Introduction: Central-line associated bloodstream infections (CLABSI) are a serious adverse event in Intensive Care Units (ICUs). Epidemiologic studies are therefore crucial for planning appropriate interventions to these complications. Objectives: To assess the occurrence of CLABSIs in an Intensive Care Center (ICC) for adults and its specialized ICUs through epidemiologic vigilance. Methods: The medical records of patients admitted to the Adult ICC of the Clinical Hospital of the Federal University of Uberlândia between March 1st and August 31st, 2016, were analyzed in an observational, descriptive study of document analysis with a quantitative approach. The criteria for the vigilance of device-associated infections were defined according to the National Healthcare Safety Network. Results: A total of 30 BSI cases out of 4265 patients-day and 3373 CL-day was observed for the studied period. The incidence rate of CLABSIs in the Adult ICC was 8.90/1,000 CL-day, while the CL utilization ratio was 0.79. The BSI indicators were calculated separately for the specialized ICUs. The incidence rate was 7.52/1,000 CL-day in the Surgical IC, 14.81/1,000 CL-day in the Neurological ICU, and 5.85/1,000 CL-day in the Clinical ICU. A. baumannii (15.2%) stood out as the most prevalent agent among the microorganisms identified, followed by S. aureus (12.1%) and S. epidermidis (12.1%). Resistance to Oxacillin was detected for 100% of Coagulase-Negative Staphylococcus strains and in 25% of S. aureus strains. Enterobacteria resistance to 3rd and 4th generation cephalosporins was 62.5% and 25% to carbapenems. In non-fermenters, resistance to carbapenems was 75%. Conclusion: The results showed differences in the incidence density of CLABSIs, highlighting on the Neurological ICU, which had a very high mean incidence when compared to other studies. These findings reinforce the importance of epidemiological survey by type of ICU.