Infecções relacionadas à assistência à saúde na Unidade de Terapia Intensiva Pediátrica de um Hospital Universitário de Minas Gerais

Abstract

Introduction: Health care-related infections (HAIs) are those acquired or manifested 72 hours after the client’s admission and which can be associated with an invasive procedure or with hospitalization itself. The consequences of the infections are numerous, such as the high mortality rate, sequelae, longer hospital stay, the increase in expenses with that patient due to the use of medications, including antimicrobials. Objectives: To analyze the incidence of HAIs and characterize the children with this diagnosis admitted to the Pediatric Intensive Care Unit (PICU) of a large hospital in Minas Gerais. Methodology: This is a descriptive, quantitative, retrospective and documentary study. Data collection was performed from medical records of children admitted to the PICU, from January 2017 to July 2019, who were diagnosed with HAIs, including data recorded by the epidemiological surveillance of the Hospital Infection Control Service (SCIH). Results: The children had an average of 34.76 (± 45.88) months of age, the main clinical diagnosis was respiratory diseases, the average length of stay in the PICU was 42.46 (± 43.53) days. The predominance among HAIs was Pneumonia associated with mechanical ventilation (VAP) with 48.70%, followed by Urinary tract infection (UTI) related to the urinary bladder catheter (CVD) with 30.80% and Primary bloodstream infection associated with laboratory-confirmed central catheter (IPCSL) related to the central venous catheter (CVC) in 20.50% of cases. The data referring to IRAS were: In the VAP and ITU, gram-negative bacteria stood out, with a resistance profile to carbapenems and sensitive, respectively, in the IPCSL gram-positive bacteria prevail, being only one with a resistance profile; the main antimicrobials used were meropenem, cefepime and vancomycin, respectively; the average time of use of mechanical ventilation (MV) was 18.26 (± 12.67) days in the VAPs, in the ITUs the use of CVD was 17.16 (± 12.59) days and in the IPCSL the average CVC utilization was 65.12 (± 71.07) days; the percentage of deaths was 15.38%. Conclusion: VAP was the prevalent infection among the HAIs followed by UTI and IPCSL. Children admitted to the PICU had a mean age in the preschool age group, with an average hospital stay longer than 30 days and had survival.