Freqüência e percentual de suscetibilidade de bactérias isoladas em pacientes atendidos na Unidade de Terapia Intensiva do Hospital Geral de Fortaleza

Abstract

Introduction: Nosocomial infections are prominent problem in hospital environment, mainly in intensive care units (ICU), where innumerous factors favoring the development of these infections are found. Objectives: To determine the frequency and the antibiotic resistance pattern of bacteria isolated from ICU patients in the General Hospital of Fortaleza (HGF). Material and methods: Bacteria were isolated in culture medium and the identification and test of susceptibility to antimicrobials was performed using MicroScan WalkWay automation device. Results: From January to December of 2002, 34% of specimens from tracheal secretion; 10% from catheter cultures; 26% from urine and 30% from the blood yielded isolates. Specimens more frequent in tracheal secretion were Pseudomonas aeruginosa (16%) e Klebsiella pneumoniae (15%). In catheter cultures, we found high prevalence of Staphylococcus negative coagulase (SNC) (25%) and Staphylococcus aureus (25%); in urine, Klebsiella pneumoniae (16%) and Pseudomonas aeruginosa (14%) were the most prevalent. From blood, we isolated mostly SNC (41%) and Staphylococcus aureus (17%). About antimicrobial susceptibility patterns of Pseudomonas aeruginosa isolated from tracheal secretion, we found a high sensitivity to piperacilin and high resistance to ceftriaxone and cefotaxime. Klebsiella pneumoniae isolated fom tracheal secretion showed high sensibility to imipenem, but no resistance to other antimicrobials althogeter. Susceptibility to ceftazidime was 54%. Isolates from catheters showed broad resistance pattern (ampicillin/sulbactam, cefepime, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, gentamicin, piperacillin/tazobactam, piperacillin, ticarcillin/clavulani acid and tobramycin) but imipenem susceptibility. In urine, the susceptibility to ciprofloxacin was 55%. Staphylococcus aureus e SNC were isolated mainly from catheter, with high susceptibility to vancomycin (100%). Discussion: Antibiotic resistance is an increasing problem challenging ICUs worldwide. Infections due to multiresistant bacteria correlate with increased morbidity and mortality in severely ill patients. Conclusion: The most important pathogens causing infections in ICU of HGF were P. aeruginosa. K. pneumoniae, Acinetobacter baumannii, S. aureus and SNC.