Keywords
Health care associated infection
Health profile
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: To describe the epidemiological profile of infections and colonizations caused by microorganisms that produce the metallobetalactamase New Delhi (MND-1) enzyme and the respective patients in a southern brazilian tertiary hospital. Methods: Retrospective descriptive study with data of patients with a positive culture for the enzyme producer, tracing the etiological agent, antibiogram, culture collection material, comorbidities and outcome. Comparisons were made using the chi-square test and risk factors for death by odds ratio. Results: There were 47 records in 41 patients, 34 infections and 13 colonizations. Klebsiella spp. was the most prevalent microorganism responsible for infections, resistant to beta-lactams and sensitive to amikacin.44,68% of the samples were urine, with 61,70% of patients using a urinary catheter. 60% were men, 58,54% over 60 years old, with high blood pressure and diabetes mellitus, these being risk factors for death. Regarding the outcome, 18 were discharged and 21 died, with 19 deaths related to the infection. Conclusion: Producers of the analyzed enzyme are linked to infections in the hospital environment. Its main agent is Klebsiella spp., focusing on the genitourinary tract, especially when using invasive devices and with a high mortality rate.
References
ASSIS, DB, et al. Infecções relacionadas à assistência à saúde Série Histórica 2004 – 2020. Boletim epidemiológico paulista. 2023; 20.
ANVISA, Programa Nacional De Prevenção E Controle De Infecções Relacionadas À Assistência À Saúde (2021-2025), Brasília, 2021.
ANVISA. NOTA TÉCNICA GVIMS/GGTES/DIRE3/ANVISA nº 01 / 2024 Orientações para vigilância das Infecções Relacionadas à assistência à Saúde (IRAS) e resistência aos antimicrobiana em serviços de saúde. Brasília, 2024.
AREND, LNVS et al. Dissemination of NDM-producing bacteria in Southern Brazil. Diagnostic Microbiology and Infectious Disease, 2023; 106: 115930.
CAMARGO CH, et al. Genomic Diversity of NDM-Producing Klebsiella Species from Brazil, 2013–2022. Antibiotics (Basel). 2022; 11(10): 1395.
CAMARGO CH. Current status of NDM-producing Enterobacterales in Brazil: a narrative review. Brazilian Journal of Microbiology, 2022; 53: 1339–1344.
DA SILVA OLIVEIRA N, et al. Mecanismos de resistência bacteriana. Revista Científica Eletrônica De Medicina Veterinária-Issn: 2009; 12(15): 1679-7353.
DUDKIEWICKZ FM, et al. Estudo da frequência e da caracterização das infecções por Klebsiella pneumoniae carbapenemase em um hospital dos Campos Gerais. Research, Society and Development, 2022; 11(16).
FARIA, LF, et al. Principais mecanismos de resistência bacteriana relacionados ao uso indiscriminado de antibióticos. Revista Saúde em Foco, 2021; 13.
FORESTO, RM, et al. Desafios da Enterobacteriaceae produtora de New Delhi Metalo-beta-Lactamase (NDM-1) multirresistente em pacientes com transplante renal. Braz. J. Nephrol. (J. Bras. Nefrol.) 2023; 45(1): 116-120.
GIACOMELLI A et al. Consumption of antibiotics at an Italian university hospital during the early months of the COVID-19 pandemic: Were all antibiotic prescriptions appropriate? Pharmacological Research, 2021; 164: 105403.
JÚNIOR JNA, et al. Controle da disseminação de microrganismos multirresistentes. In: Agência Nacional de Vigilância Sanitária (BR). Segurança do Paciente em Serviços de Saúde: Higienização das Mãos. Brasília: Anvisa; 2009; 105(4): 31-37.
LEAL MA e FREITAS-VILELA AA. Costs of healthcare-associated infections in an Intensive Care Unit. Rev Bras Enferm. 2021; 74(1): 20200275.
LO S, et al. Simultaneous hospital outbreaks of New-Delhi metallo-beta-lactamase-producing Enterobacterales unraveled using whole-genome sequecing. Microbiology Spectrum, 2022; 10.
MELLO MS e OLIVEIRA AC. Panorama das ações de combate à resistência bacteriana em hospitais de grande porte. Rev. Latino-Am. Enfermagem. 2021; 29: 3407.
MONTEIRO, J. ABBOUD, et al. NDM-producing Enterobacterales prevalence associated to COVID-19 in a tertiary hospital. Braz J Infect Dis. 2023; 27(1): 102735.
ROSA TJ, et al. Metallobetalactamase New Delhi: a review. Revista Brasileira de Análises Clínicas, 2016.
SCHIRMER AA, et al. Enterobactérias produtoras de carbapenemase (KPC): alternativas para farmacoterapia atual. Brazilian Journal of Surgery and Clinical Research - BJSCR. 2020; 33(3): 62-69.
SOARES CRP, et al. First report of a blaNDM-resistant gene in a Klebsiella aerogenes clinical isolate from Brazil. Journal of the Brazilian Society of Tropical Medicine, 2021; 54: 2622020.
SOARES e V VIEGAS D. Emergência de Enterobacterales produtoras de metallo-beta-lactamase em um hospital de referência para COVID-19. Revista Brasileira de Análises Clínicas (RBAC), 2022; 54(2): 188–192.
SOUZA ES, et al. Mortalidade e riscos associados a infecção relacionada à assistência à saúde. Texto Contexto Enferm, Florianópolis, 2015; 24(1): 220-8.
VIVAS R, et al. Prevalence of Klebsiella pneumoniae carbapenemase - and New Delhi metallo-beta-lactamase-positive K. pneumoniae in Sergipe, Brazil, and combination therapy as a potential treatment option. Journal of the Brazilian Society of Tropical Medicine. 2020; 53: 20200064.
YONG D, et al. Characterization of a new metallo-beta-lactamase gene, bla (NDM1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India. Antimicrob Agents Chemother. 2009; 53(12): 5046-54.