Perfil microbiológico das pneumonias bacterianas associadas à assistência à saúde de pacientes internados em unidades de terapia intensiva de um hospital privado de Fortaleza, Ceará

Abstract

Healthcare-Related Infections (HAIs) are one of the leading causes of mortality in hospitalized patients. In ICU environments there is a high prevalence of these infections, with Pneumonia being the most deadly HAI. In recent years, the rates of microorganisms resistant to antimicrobials have been growing exponentially, imposing severe restrictions on the options available for the clinical treatment of bacterial infections. Thus, knowledge of the microbiological profile of bacteria isolated from patients in a hospital is necessary, as well as knowledge of the microbial sensitivity profile. The objective of this study was to analyze the microbiological profile of bacteria isolated from patients with healthcare-associated pneumonia in a hospital belonging to a health insurance company. To this end, data were collected from the Hospital Infection Control Committee (HICC) IRAS notifications and the reports of Tracheal Aspirate (TAS) and Bronchoalveolar Lavage (BAL) cultures. Data were compiled and analyses were performed by Excel 2019 software. Variables analyzed were gender, age group, types of healthcare-associated pneumonia, bacterial species, resistance profiles, reason for hospitalization, and outcome. The sample consisted of 72 patients and 80 bacterial isolates, with male gender over 60 years old being the most prevalent patient profile. 70.8% (n= 51) of the reasons for admission were for COVID-19. 92.5% (n= 74) were Mechanical Ventilator Associated Pneumonias (VAP), in which Gram negative microorganisms were the most prevalent cause of SSRIs, with 97.5% (n=78). Acinetobacter baumanii was the species most responsible for pneumonia with 40% prevalence (n=32), in which all isolates were resistant to carbapenems. Pseudomonas aeruginosa 22.6% (n=18) and Klebsiella pneumoniae 20% (n=16), were other bacteria with high prevalence. The main resistance mechanism found was enzymatic, in which all were serine-β-lactamases, with KPC, AmpC and ESBL types being the most prevalent. The median number of days between hospitalization and notification of IRAS was 26 days (8-101). 58.3% (n=42) had death as the outcome. Of the outcomes by death, 61.2% of patients had VAP. In conclusion, with the results found, the detection of the microbiological profile of an assistance unit is necessary to know the most prevalent microorganisms and resistance profiles and to enable the most correct empirical antimicrobial treatment.