Perfil epidemiológico de enterobacteriaceae resistentes aos carbapenêmicos e de enterococcus spp. resistentes à vancomicina isolados de cultura de vigilância, em um hospital terciário de Fortaleza, Ceará

Abstract

The indiscriminate and excessive use of antibiotics has been one of the major factors for the worsening of the bacterial resistance, which at the hospital results in an emerging public health problem. This study aimed to determine the epidemiological profile of Carbapenem-Resistant Enterobacteriaceae (CRE) and Vancomycin-Resistant Enterococci (VRE) isolated from a surveillance culture at a tertiary care hospital in Fortaleza, Ceará, from January to October 2018. This is a descriptive, retrospective study, with a quantitative approach, based on the analysis of the results of culture exams patients in the referred hospital. The data were collected from the microbiology sector and for storage and analysis, Microsoft Office Excel was used. In the study period, were isolated 271 samples of cultured positive rectal swab for Enterobacteriaceae resistant to carbapenems and Enterococcus spp. resistant to vancomycin. Of these, 153 (56.46%) were carbapenem resistant Klebsiella pneumoniae, 2 (0.74%) were carbapenem resistant Escherichia coli, 99 (36.53%) vancomycin resistant Enterococcus faecium and 17 (6.27%) were vancomycin resistant Enterococcus faecalis. The profile of patients with a positive CRE culture was 60 years or older (42.58%), female (52.26%) and the most frequent hospital sector was the ICU (68.39%). As to the sensitivity profile of CRE, the microorganisms were more sensitive to amikacin (99.35%), tigecycline (98.86%) and colistin (98.70%). With regard to VRE, of the 116 isolates, 99 were E. faecium and 17 E. faecalis, the most frequent age group of patients with these isolates was 60 years old or older (47.41%), with a predominance of males (54,31%) and the most prevalent sector was the ICU (46.55%). Regarding the sensitivity profile of VRE, linezolid was the most sensitive antimicrobial (100%). The results of this study contribute to the knowledge of the epidemiological profile and sensitivity of these local microorganisms, in order to contribute to the implementation of prevention, control and treatment measures.