Análise epidemiológica das infecções hospitalares ocorridas em pacientes internados no serviço de hematologia do Hospital Universitário Walter Cantídio em 2003

Abstract

Hospital infections represent an important cause of morbidity and mortality worldwide. These are the most common complications in hospitalized patients, being responsible for the increase in hospitalization time and costs, direct and indirect, with health. The patient's acquired infection after the patient's admission, manifested during hospitalization or after discharge, is considered as hospital, when it may be related to hospitalization or hospital procedures. We conducted an observational, descriptive, cross-sectional study to analyze the epidemiology of hospital infections that occurred in hematological patients admitted to the Hematology Service of Walter University Hospital between 01/01/2003 and 12/31/2003. In approximately 31% of hospitalizations in 2003, there was at least one episode of hospital infection, which corresponded to a Hospital Infection Rate and a Hospital Infection Patients Rate of 39.5% and 27.6%, respectively. The main site of hospital infections was infection associated with the use of a vascular catheter, followed by skin and lung. However, in 13.7% of fever episodes, the infectious focus was not defined; fever of obscure origin. There was microbiological confirmation in 47% of hospital infections. The most common infectious agent was S. Aureus, present in 37.1% of the cases. Next, the following agents were highlighted: Pseudomonas Aeruginosa and Klebsiella spp. Among the several factors that presented a significant association with the presence of hospital infection, the presence and severity of neutropenia stood out (p < 0.001). There was a significant difference in the mean duration of hospitalizations due to the presence and origin of the infection; number of cases of infection by hospitalization and the presence of neutropenia. Of the patients with hospital infection, 47% died; and in approximately 39% of these there was an association with the infectious process. The recognition of risk factors for infection allows the identification of patients, procedures and hospital units at high risk for the development of nosocomial infection, allowing the optimization of activities and, consequently, of prevention costs.