Infecção de corrente sanguínea associada a cateter venoso central: incidência, agentes etiológicos e resistência bacteriana

Gisele Cristiane da Silva Dias; Jaqueline Resende; Astrídia Marília de Souza Fontes; Lucio Borges de Araújo; Denise Von Dolinger de Brito Röder

doi:10.17696/2318-3691.29.1.2022.1989

Authors

Gisele Cristiane da Silva Dias Faculdade de Medicina da Universidade Federal de Uberlândia, Uberlândia, MG, Brasil https://orcid.org/0000-0001-8565-3446
Jaqueline Resende Hospital das Clínicas da Universidade Federal de Goiás, Goiás, GO, Brasil https://orcid.org/0000-0003-0574-7210
Astrídia Marília de Souza Fontes Hospital de Clínicas da Universidade Federal de Uberlândia, Uberlândia, MG, Brasil https://orcid.org/0000-0002-1701-333X
Lucio Borges de Araújo Faculdade de Matemática da Universidade Federal de Uberlândia, Uberlândia, MG, Brasil https://orcid.org/0000-0002-2230-203X
Denise Von Dolinger de Brito Röder Instituto de Ciências Biomédicas da Universidade Federal de Uberlândia, Uberlândia, MG, Brasil https://orcid.org/0000-0003-4987-3382

DOI:

https://doi.org/10.17696/2318-3691.29.1.2022.1989

Keywords:

Public Health Surveillance; Health Status Indicators; Intensive Care Units

Abstract

Introduction: Central-line associated bloodstream infections (CLABSI) are a serious adverse event in critical care units. Objectives: To assess the rate of CLABSIs in an Intensive Care Center (ICC) for adults and its specialized ICUs, highlighting the etiological agents and resistance profile. Methods: The medical records of patients admitted between March 1st and August 31st, 2016, were analyzed in an observational, retrospective and descriptive study of document analysis with a quantitative approach. Results: A total of 30 BSI cases out of 4,265 patients-day and 3,373 device-days was observed for the studied period. The incidence rate of CLABSIs in the Adult ICC was 8.90 per 1,000 device-days, while the central line utilization ratio was 0.79. The BSI indicators were calculated separately for the specialized ICUs. The incidence rate was 7.52 per 1,000 device-days in the Surgical ICU, 14.81 per 1,000 device-days in the Neurological ICU, and 5.85 per 1,000 device-days in the Clinical ICU. Acinetobacter baumannii stood out as the most frequent (15.2%) agent among the microorganisms identified, followed by Staphylococcus aureus (12.1%) and Staphylococcus epidermidis (12.1%). Resistance to Oxacillin was detected for 100% of Coagulase-Negative Staphylococcus strains and in 25% of Staphylococcus aureus strains. Enterobacteria resistance to extended-spectrum cephalosporins was 62.5% and 25% to carbapenems. In non fermenters, resistance to carbapenems was 75%. Conclusion: The results have showed differences in the CLABSI rates between specialized ICUs. Gram-negative pathogens stood out as the most frequently isolated etiologic agents. The percentage of gram negative bacteria resistant to carbapenems and extended-spectrum cephalosporins was higher than that reported by other authors. These findings strengthen the importance of epidemiological surveillance according to the type of ICU.

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Central line-associated bloodstream infection: incidence, etiological agents and bacterial resistance

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