Descrição do uso de antibióticos e perfil microbiológico durante a pandemia por COVID-19 em um hospital do sistema suplementar de saúde de Fortaleza

Abstract

COVID-19 is an infectious disease caused by the new coronavirus, first identified in December 2019 in Wuhan, China. Since it was identified, the disease has caused thousands of deaths worldwide. The rapid spread of COVID-19 has been associated with an increase in antibiotic consumption. The indiscriminate use of antibiotic therapy can cause subsequent harm related to antimicrobial resistance. Bacterial co-infections associated with SARS-CoV-2 were related to worse clinical conditions and unfavorable outcomes. This study aimed to describe the profile of the use of antibiotics for the treatment of COVID-19 and to trace the microbiological profile of patients admitted to a private hospital in Fortaleza. This is a retrospective, descriptive and cross-sectional study with real-world data. The study population consisted of patients over 18 years of age, hospitalized in open (wards) and closed units (ICUs) from January to June 2021, who tested positive for SARS-CoV-2 and used antibiotic therapy. Respiratory cultures and blood cultures of these patients were evaluated to identify the most isolated bacteria during this period. Of the 2326 patients included in the study, most were men, with a mean age of 55.38 years, and who remained hospitalized for a period of 8-14 days. Regarding the use of antibiotics, 5589 prescriptions were identified. Ceftriaxone was the most prescribed (1530), followed by piperacillin/tazobactam (1021), meropenem (661), and levofloxacin (462). Antibiotics were used more in ICUs than inwards. Of the patients who used antibiotics, 52.11% (1212/2326) had a positive respiratory culture or blood culture for bacteria, of which 53.24% (575/1080) were gram-negative and 46.76% (505/1080) were gram-negative. positive. Acinetobacter baumannii (188), Staphylococcus epidermidis (188), Klebsiella pneumonia (141), Pseudomonas aeruginosa (134), and Staphylococcus haemolyticus (130) were the most prevalent bacteria in the positive cultures. Among the gram-negative bacteria, 64.89% (316) showed CRE (Carbapenem-Resistant Enterobacteriaceae) profile and 34.70% (169) were ESBL (Extended Spectrum Beta-lactamase) producers. Regarding the gram-positives, only 01 MRSA (Methicillin-Resistant Staphylococcus aureus) was isolated and 01 VRE (VancomycinResistant Enterococci). Thus, identifying the profile of antibiotic use and knowing the microbiological profile of health units is essential to promoting an assertive therapy aimed at therapeutic success.