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Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2022.tde-08112022-162816
Document
Author
Full name
Mateus Rennó de Campos
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2022
Supervisor
Committee
Bollela, Valdes Roberto (President)
Andrade, Leonardo Neves de
Rodrigues, Fernando Bellissimo
Title in Portuguese
Avaliação do perfil de resistência de bactérias isoladas de hemoculturas em um hospital terciário no período de 2009 a 2018
Keywords in Portuguese
Controle de infecções
Infecção hospitalar
Infecções bacterianas
Infectologia
Resistência microbiana as drogas
Abstract in Portuguese
Infecções associadas a assistência a saúde são um problema crescente, e a o aumento na resistência bacteriana aos antimicrobianos causa maior dificuldade no tratamento levando a maior morbimortalidade. Conhecer o perfil de resistência aos antimicrobianos do serviço e importante para o uso racional de antimicrobianos. O objetivo deste trabalho foi avaliar o perfil de resistência das bactérias isoladas em hemoculturas em um hospital terciário. Realizou-se um estudo retrospectivo descritivo, utilizando os resultados de hemoculturas coletadas entre 2009 e 2018. De um total de 165.844 hemoculturas, 20.476 eram positivas. Selecionando a primeira amostra de cada agente, para cada paciente, nas duas unidades do hospital, avaliamos 17.698 hemoculturas. As bactérias mais frequentes foram estafilococos coagulase negativos (46,29% do total), Staphylococcus aureus (10,13%), Klebsiella pneumoniae (7,53%), Escherichia coli (6,72%), Acinetobacter baumannii (4,73%) e Pseudomonas aeruginosa (4,20%). O Acinetobacter baumannii apresentou os maiores índices de resistência, com destaque para a sensibilidade ao meropenem que diminuiu de 64,04% em 2009 para 24% em 2018. O Staphylococcus aureus apresentou 45,27% de resistência a oxacilina. A Escherichia coli apresentou um aumento importante na resistência as cefalosporinas, com perfil ESBL em 9,26% em 2009 e 46,91% em 2018, e quinolonas (20,37% de resistência em 2009, 50,61% em 2018). De maneira geral, a presença de resistência aos antimicrobianos esteve associada ao uso prévio de maior numero de antibióticos.
Title in English
Evaluation of the resistance profile of bacteria isolated from blood cultures in a tertiary care hospital from 2009 to 2018
Keywords in English
Antibiotic resistance
Bacterial infection
Healthcare-associated infection
Infection control
Infectious diseases
Abstract in English
Healthcare-associated infections are a growing problem worldwide, and the increasing bacterial resistance to antibiotics leads to a more difcult treatment, resulting in greater morbidity and mortality. Knowing the local resistance patterns is essential for a rational use of antibiotics. This study's objective was to describe the resistance pattern of bacteria isolated from blood cultures in a tertiary-care hospital. We designed a retrospective descriptive study, evaluating blood cultures from 2009 to 2018. From a total of 165.844 samples, 20.476 were positive for bacterial growth. After selecting only the first isolate for each patient, we evaluated 17.698 blood culture isolates. The most frequent species were coagulase-negative staphylococci (46,29%), Staphylococcus aureus (10,13%), Klebsiella pneumoniae (7,53%), Escherichia coli (6,72%), Acinetobacter baumannii (4,73%) and Pseudomonas aeruginosa (4,20%). Acinetobacter baumannii had the worst resistance prole, with emphasis on meropenem sensitivity, which fell from 64,04% in 2009 to 24% in 2018. Staphylococcus aureus was resistant to oxacillin in 45,27% of isolates. Escherichia coli had a significant increase in cephalosporin resistance, with an ESBL pattern growing from 9,26% in 2009 to 46,91% in 2018, and quinolone resistance (20,37% resistance in 2009 to 50,61% in 2018). In general, antibiotic resistance was associated with a prior use of a greater number of antibiotics.
 
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Publishing Date
2022-11-23
 
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