Keywords
Outcome assessment health care
Enterobacteriaceae infections
Drug resistance microbial
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Abstract
Objective: Evaluate the microbial resistance (RM) profile of enterobacteria involved in healthcare-associated infections (IRAS). Methods: A cross-sectional, descriptive and analytical study was carried out in a public hospital between 2019 and 2024. Samples from patients over 18 years of age with positive culture results for infections caused by enterobacteria were included, n = 963. Data on the microbiological culture profile and the MR profile of enterobacteria were collected. For statistical analysis, Person's Chi-square test or Fisher's Exact test were used to compare the proportions of categorical variables. Results: The study findings indicated a prevalence of 40.9% for enterobacteria, with an increase between 2023 and 2024, particularly Klebsiella pneumoniae (40.4%) and Escherichia coli (20.4%). An increased trend of MR to Cefepime was observed in Klebsiella pneumoniae, resistance to Gentamicin in Escherichia coli and Enterobacter cloacae (without statistical evidence), and resistance to Meropenem in Klebsiella pneumoniae (p=0.389), Escherichia coli (p=0.048), and Serratia marcescens (p=0.236), with statistical significance for Escherichia coli, demonstrating a variation in MR between the years analyzed. Conclusion: The importance of monitoring IRAS and intensifying patient safety protocols is evident.
References
ABDELAZIZ SA, et al. Antimicrobial resistance burden pre and post-COVID-19 pandemic in Egypt. Scientific Reports, 2024; 14: 7176.
AGÊNCIA NACIONAL DE VIGILÂNCIA SANITÁRIA (ANVISA BR). 2021. Plano Nacional de Prevenção e Controle da Infecção Relacionada à Assistência à Saúde (2021–2025). Brasília: ANVISA. Disponível em: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/publicacoes/pnpciras_2021_2025.pdf. Acesso em: 14 abr. 2025.
AGÊNCIA NACIONAL DE VIGILÂNCIA SANITÁRIA (ANVISA BR). 2023. Boletim Segurança do Paciente e Qualidade em Serviços de Saúde n. 31: Avaliação dos Indicadores Nacionais das Infecções Relacionadas à Assistência à Saúde. Disponível em: https://app.powerbi.com/view?r=eyJrIjoiOTE3M2RhODAtN2M1Yi00YTc0LWJmMWYtMzNlY2RiZGNlMmNhIiwidCI6ImI2N2FmMjNmLWMzZjMtNGQzNS04MGM3LWI3MDg1ZjVlZGQ4MSJ9. Acesso em: 22 abr. 2025.
AIESH BM, et al. Nosocomial infections in the surgical intensive care unit. BMC Infectious Diseases, 2023; 23(1): 686.
ALMEIDA APC, et al. Long-term occurrence of multiple antimicrobial drug resistant Klebsiella pneumoniae isolates harboring virulent potential in a tertiary hospital from Brazil. Brazilian Journal of Microbiology, 2024; 55(3): 2313–2320.
ANTOCHEVIS LC, et al. World Health Organization priority antimicrobial resistance in healthcare-associated bloodstream infections in Brazil (ASCENSION). Lancet Regional Health – Americas, 2025; 43: e101004.
ANTONELLI A, et al. Healthcare-associated infections and antimicrobial use in acute care hospitals. BMC Infectious Diseases, 2024; 24(1): 632.
AVERSHINA E, et al. Fighting antibiotic resistance in hospital-acquired infections: current state and emerging technologies in disease prevention, diagnostics and therapy. Frontiers in Microbiology, 2021; 12: 707330.
AZZAM A, et al. Prevalence and molecular characterization of ESBL-producing Enterobacteriaceae in Egypt. Antimicrobial Resistance & Infection Control, 2024; 13: 145.
BARROSO LK, et al. The economic impact of healthcare-associated infections in hospitalization in intensive care units. Revista Eletrônica Acervo Saúde, 2023; 23(5): e13053.
CÂNDIDO TL, et al. Prevenção e controle de infecções relacionadas à assistência à saúde em Unidade de Terapia Intensiva Adulto: o olhar da equipe de enfermagem. Revista Eletrônica Acervo Saúde, 2024; 24(7): e16260.
EL-MASRY E, et al. Prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae among clinical isolates in Turaif General Hospital, northern borders – Saudi Arabia. Journal of Infection in Developing Countries, 2023; 17(4): 477–484.
FOCHAT RC, et al. Prevalence and molecular characterization of carbapenem-resistant Enterobacterales in Brazil during and post SARS-CoV-2 pandemic. Brazilian Journal of Microbiology, 2024; 55(4): 3873–3884.
ISMAEL YH, et al. Clinical and microbiological profile of healthcare-associated infections in a tertiary hospital: comparison between a cohort of hospitalized patients during pre-pandemic and COVID-19 pandemic periods. American Journal of Infection Control, 2024.
JALALI Y, et al. A comprehensive report on ESBL-producing bacteria and trends in antibiotic resistance in Slovakia. Antibiotics, 2024; 17(11): 1517.
JI B, YE W. Prevention and control of hospital-acquired infections with multidrug-resistant organism: a review. Medicine (Baltimore), 2024; 103(4): e37018.
KAMAKI AM, et al. O resgate da cultura de higienização das mãos nos serviços de saúde no contexto pandêmico. RECIMA21 - Revista Científica Multidisciplinar 2021; 2(11): e211960.
KUNTAMAN K, et al. Antimicrobial resistance among common bacterial pathogens in Indonesia: a systematic review. Lancet Regional Health – Southeast Asia, 2024; 26.
LIU X, et al. A systematic review and meta-analysis of risk factors associated with healthcare-associated infections among hospitalized patients in Chinese general hospitals from 2001 to 2022. Journal of Hospital Infection, 2023; 135: 37–49.
MACZYNSKA B, et al. Evolution of antibiotic resistance in Escherichia coli and Klebsiella pneumoniae clinical isolates in a multi-profile hospital over 5 years (2017–2021). Journal of Clinical Medicine, 2023; 12(6): 2414.
MEIRELLES LC, et al. Antimicrobial prescription and bacterial resistance in a Brazilian intensive care unit. Revista de Epidemiologia e Controle de Infecção, 2023; 14(1): e19024.
MELO LSW, et al. Success factors of a collaborative project to reduce healthcare-associated infections in intensive care units in Northeastern Brazil. Revista Brasileira de Terapia Intensiva, 2022; 34(3): 327–334.
NAGHAVI M, et al. Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050. Lancet, 2024.
OLIVEIRA RD, et al. Tackling healthcare-associated infections in Brazilian intensive care units: we need more than collaboration. Revista Brasileira de Terapia Intensiva, 2022; 34(3): 313–315.
PATINO AG. Conceitos básicos sobre as infecções relacionadas à assistência à saúde. RSC, 2024; 20(3): 3337–3347.
PRICE L, et al. Effectiveness of national and subnational interventions for prevention and control of health-care-associated infections in acute hospitals in high-income and upper-middle-income countries: a systematic review update. The Lancet Infectious Diseases, 2023.
RAOOFI S, et al. Global prevalence of nosocomial infections: a systematic review and meta-analysis. PLoS One, 2023; 18(1): e028140.
SESAB. 2025. Hospital Geral Prado Valadares. Salvador: SESAB. Disponível em: https://www.saude.ba.gov.br/hospital/hospital-geral-prado-valadares. Acesso em: 25 jun. 2025.
SILVA LG, et al. Uso indiscriminado de antimicrobianos no contexto da Covid-19: aumento da resistência bacteriana. Revista Eletrônica Acervo Saúde, 2024; 24(5): e15880.
STROBE. 2025. Strengthening the reporting of observational studies in epidemiology. Disponível em: https://www.strobe-statement.org/checklists/30. Acesso em: 25 jun. 2025.
QUARESMA SM, et al. Comparação do perfil de utilização de antimicrobianos nas diferentes ondas da Covid-19 em um hospital universitário na cidade de Manaus-AM. Revista Eletrônica Acervo Saúde 2024; 24(5): e15960.
VALENTIM NRVS. Effectiveness of chlorhexidine in bucal hygiene for the prevention of pneumonia associated with mechanical ventilation. REVISA, 2022; 11(3): 314–325.
WORLD HEALTH ORGANIZATION. 2024. WHO updates list of drug-resistant bacteria most threatening to human health. Disponível em: https://www.who.int/news/item/17-05-2024-who-updates-list-of-drug-resistant-bacteria-most-threatening-to-human-health. Acesso em 29 mai. 2025.