Análise epidemiológica da letalidade relacionada a infecção por Staphylococcus spp. Resistente à Oxacilina em neonatos críticos

Abstract

Background and Objectives: Neonatal care is one of the main causes of death in neonates, resulting from Healthcare Associated Infections (HAIs). In recent years, there has been a considerable increase in oxacillin-resistant Staphylococcus (ORS), which is extremely worrying because it has many virulence factors, favoring antimicrobial resistance and lethality. Measures to reduce cases of bacterial infections in these units are highly necessary. The aim of this study is to analyze lethality associated with invasive ORS infections in a NICU. Methods: This is a retrospective study, carried out through the analysis of electronic medical records of neonates admitted to the NICU between january 2015 and june 2022. The research exclusively involved neonates who had infections caused by the species Staphylococcus resistant to oxacillin. The epidemiological analysis focused on examining the agents responsible for infections and their resistance to antimicrobials, as well as the case fatality rate. Results and Discussion: During the period, 177 neonates had at least one infectious episode due to ORS, 36 (20.3%) died. In the last 7 years, there were 239 episodes of infection, where the main infectious site was blood, with 233 (97.4%) isolates. The agent most commonly found in infections was S. epidermidis (61.5%). The highest fatality rate was in 2017 with 36%. Of the isolates analyzed, it was observed that 100% of the neonates who died had multidrug resistance to antimicrobials. The results point to a decrease in the frequency of cases and deaths from ORS over time, but the high rate of neonatal lethality remains high.