Resumen
Objetivo: Evaluar el perfil de resistencia microbiana (MR) de las enterobacterias implicadas en las infecciones asociadas a la atención médica (IRAS). Métodos: Se realizó un estudio transversal, descriptivo y analítico en un hospital público entre 2019 y 2024. Se incluyeron muestras de pacientes mayores de 18 años con resultados positivos en cultivos para infecciones causadas por enterobacterias (n = 963). Se recopilaron datos sobre el perfil de cultivo microbiológico y el perfil deRM de las enterobacterias. Para el análisis estadístico, se utilizaron la prueba de Chi-cuadrado de Person o la prueba Exacta de Fisher para comparar las proporciones de las variables categóricas. Resultados: Los hallazgos del estudio indicaron una prevalencia del 40,9% para enterobacterias, con un aumento entre 2023 y 2024, particularmente Klebsiella pneumoniae (40,4%) y Escherichia coli (20,4%). Se observó una tendencia al aumento de la RM a Cefepima en Klebsiella pneumoniae, resistencia a Gentamicina en Escherichia coli y Enterobacter cloacae (sin evidencia estadística), y resistencia a Meropenem en Klebsiella pneumoniae (p=0,389), Escherichia coli (p=0,048) y Serratia marcescens (p=0,236), con significancia estadística para Escherichia coli, lo que demuestra una variación en la resistencia microbiana entre los años analizados. Conclusión: Es evidente la importancia de IRAS e intensificar los protocolos de seguridad del paciente.
Referencias
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.
