ANALYSIS OF THE CLINICAL AND MICROBIOLOGICAL PROFILE OF HEALTHCARE-ASSOCIATED INFECTIONS IN AN ICU IN NORTHEAST BRAZIL

Abstract

Objective: To analyze the clinical and microbiological profile of patients who develop healthcare-associated infections (HAIs) in an intensive care unit in northeastern Brazil. Methods: This is a retrospective, analytical, cross-sectional study conducted with medical records, antibiograms, and clinical evaluation forms from December 2018 to December 2020. Results: In total, 471 patients were admitted and 28 were diagnosed with HAIs. In these patients, the mean age was 60.5 years, 64.3% were men, and 86% were admitted for clinical pathology evaluation. The main reason for hospital admission was stroke (32%). Invasive procedures were performed in 93% of patients, with a mean device stay of 30.6 days. There was a statistical association between respiratory infection and mechanical ventilation (p = 0.001); urinary tract infection and indwelling bladder catheterization (p = 0.03). The most prevalent pathogen in respiratory, urinary and bloodstream topography was Pseudomonas aeruginosa. It was demonstrated that the length of stay in intensive care greater than or equal to 25 days was statistically significant with P. aeruginosa infection (p = 0.01), resistance to antibiotic therapy with ceftriaxone or ceftazidime (p = 0.01) and piperacillin-tazobactam (p = 0.04). Conclusion: Pseudomonas aeruginosa was the main causative agent of HAI, with a high resistance profile to the empirical therapy of choice. The highest rates refer to pneumonia associated with mechanical ventilation. Antipseudomonal targeted therapies are strongly indicated.