Infecções por Acinetobacter baumannii em Unidades de Terapia Intensiva Neonatal: fatores de risco, impacto na mortalidade e medidas de controle - uma revisão da literatura

Abstract

Healthcare-associated infections (HAIs) have grown worldwide and affect patients admitted to Neonatal Intensive Care Units (NICUs). This unit admits premature neonates, with low weight and using invasive devices, conditions considered risk factors for HAIs. Acinetobacter baumannii is a Gram-negative microorganism that causes HAIs particularly in critical units, such as the NICU, being responsible for raising the mortality rate of newborns, which happens due to the high capacity for survival and colonization of the bacteria in the environment as well as the great antimicrobial resistance it presents. Given the relevance of this microorganism, it is essential to know the factors that contribute to HAIs cases and the frequency with which they appear. Thus, the aim of this study was to review the literature on the occurrence of HAI by A. baumannii in the NICU, as well as the associated risk factors and control measures. This microorganism is the species of the genus most found in NICUs, capable of colonizing the surface of medical equipment, the skin and mucous membranes of human beings, which facilitates the dissemination and appearance of HAIs that mainly affect the bloodstream and respiratory tract of neonates. Colonization can stimulate the formation of biofilms and contribute to the emergence of resistant strains of A. baumannii. In the NICU, the vast majority of them show resistance to carbapenems, making the treatment of HAI difficult and establishing a need for combined antibiotic therapy, beyond increasing the mortality rate. A. baumannii can cause up to 80% of deaths in neonates infected by this bacterium and this highlights the importance of infection control measures and analysis of the epidemiological profile of each NICU in order to follow with an adequate treatment.