Características microbiológicas e clínicas das infecções por Acinetobacter spp. e Pseudomonas aeruginosa em Unidade de Terapia Intensiva Cardíaca de um Hospital Universitário do Rio de Janeiro

• Ano de defesa: 2012
• Autor(a) principal: Lobo, Caroline Zapater
• Orientador(a): Marques, Elizabeth de Andrade
• Banca de defesa: Abreu, Thalita Fernandes de , Silva, Maria Virgínia Godoy da , Merquior, Vania Lucia Carreira
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade do Estado do Rio de Janeiro
• Programa de Pós-Graduação: Programa de Pós-Graduação em Microbiologia
• Departamento: Centro Biomédico::Faculdade de Ciências Médicas
• País: BR
• Palavras-chave em Português: A.baumannii. P. aeruginosa; Infecções; Cirurgia cardíaca; Infecção hospitalar; Pseudomonas aeruginosa; Infecções por Acinetobacter; Unidade de Terapia Intensiva
• Palavras-chave em Inglês: A. baumannii. P. aeruginosa; Infections; Cardiac surgery
• Área do conhecimento CNPq: CNPQ::CIENCIAS BIOLOGICAS::MICROBIOLOGIA::MICROBIOLOGIA APLICADA
• Link de acesso: http://www.bdtd.uerj.br/handle/1/14424

Infections in cardiac surgery still have an important scenario infections associated with health assistance(IAHA), favoring acquisition of the patients to infection by microrganisms multiresistants. This work aimed to avaluate the profile of the resistance antimicrobial, to verify the presence of genes encoding enzymes of types oxacilinases and metallo-beta-lactamases and describe demographic and clinical caracteristics of inpatients colonized/infected by Acinetobacter spp. and P. aeruginosa in Cardiac Care Center the Pedro Ernesto University Hospital during the period 2005 to 2010. Most of 46 samples of Acinetobacter spp. and 35 the P. aeruginosa were the respiratory origen and and blood. Most sample A.baumannii showed higher percentages of resistance to: ceftazidime, piperacilin-sulbactam, ciprofloxacin, ceftriaxone and CIM &#8805;32 μg/mL for carbapenems. A sample was resistant a polymyxin B. The gene blaOXA-23 was detected in 65% of the samples and a sample showed gene blaOXA-24.The genes blaOXA-58-like e blaOXA-143 not were detected. For P. aeruginosa the percentage of resistance to all antimicrobials was less than 32%. Four samples showed intermediate resistance to polymyxin B and no gene the resistance was detected.The charts of all patients were analyzed in order to associated the clinical caracteristics with infections processes identified and the clinical outcome. The analyses by type of microrganism associated with infections process over the age of 70 years, DM and use mechanical ventilation for prolonged was higer in the patients with infection by P. aeruginosa. The IAM and the ICC of previous hospitalizations and complications (cardiogenic shock and arrhythmia) had an impact on mortality in series of patients (p<0,05). The renal failure among all comorbitidies was the only one that was associated with mortality (OR=8,3). There was no association between mortality and the organism causing the infection (Acinetobacter spp. p=0,3 and P.aeruginosa p=0,2). Two cases of mediastinitis of Acinetobacter spp. and two cases of P. aeruginosa was observed. It was an umprecedented finding in Brazil at that moment.