Palavras-chave
Betalactamases
Carbapenêmicos
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Resumo
Objetivo: Relatar primeiro caso de infecção nosocomial por Acinetobacter baumannii produtora de carbapenemase do tipo IMP no estado do Piauí, Brasil. Detalhamento do caso: Indivíduo de 37 anos, com pneumonia associada à ventilação mecânica, tratado com uma combinação de antibióticos, incluindo meropenem e polimixina B, vítima de ferimento por arma de fogo na região da face, procedente de um serviço de saúde no norte do estado, foi admitido na Unidade de Terapia Intensiva de um hospital universitário no estado do Piauí, nordeste do Brasil. No serviço de origem realizou-se intubação orotraqueal, analgesia, sedação e profilaxia com ceftriaxona (2g, IV, 12/12h) e clindamicina (600mg, IV, 6/6h), devido fratura contaminada causada pelo disparo. Chegou hemodinamicamente estável, sem uso de drogas vasoativas e ausência de febre. Foi submetido a neurocirurgia no mesmo dia que deu entrada no hospital universitário, mantendo antibioticoterapia profilática com ceftriaxona e clindamicina. Considerações finais: As polimixinas são drogas utilizadas como última linha de tratamento de infecções graves por bactérias gram-negativas, devido seus relatos de toxicidade nefrológica e neurológica. O manejo realizado pela Comissão de Controle de Infecções Relacionadas à Assistência à Saúde da instituição impediu a disseminação da resistência, destacando a importância de estratégias de controle em ambientes hospitalares.
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