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Etiologia e resistência bacteriana em unidades de terapia intensiva através de culturas de vigilância

机译:重症监护病房的病原学和细菌耐药性通过监测培养

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摘要

The existence of pathogens with high antimicrobial resistance, colonizing the skin and mucous membranes of hospitalized patients, increases the risk of serious infections. Thus surveillance cultures are important to identify these microorganisms and minimize their propagation to other individuals. This research used surveillance cultures to determine the resistance profile existent in bacteria colonizing 114 patients admitted in Intensive Care Units (ICUs) for 7 or more days. For this purpose, manual methods of phenotypic identification, antimicrobial susceptibility and phenotypic tests for the indication of β-lactamase’ production were used. From the Staphylococcus spp. isolated, 89% (98/110) were resistant to oxacillin, 39% (52/133) of Enterobacteriaceae were producers of Extended Spectrum β-Lactamases, 57.5% (23/40) of Pseudomonas aeruginosa were producers of AmpC β-Lactamase and 81% (30/37) of Acinetobacter spp. were resistant to carbapenems. Among the studied clinical variables, it was found a significant statistical association between the use of carbapenems and colonization by bacteria resistant to these antibiotics. These high indexes reflect the current epidemiological tendency of high resistant bacteria growth, making essential the implementation of surveillance measures, isolation and rationalization of antibiotic use to minimize the dissemination of these pathogens.
机译:具有高抗药性的病原体的存在,使住院患者的皮肤和粘膜定殖,增加了严重感染的风险。因此,监视培养对于识别这些微生物并使它们向其他个体的传播最小化非常重要。这项研究使用监视文化来确定在重症监护病房(ICU)住院7天或更长时间的114名患者中细菌定植的耐药性情况。为此,使用了手工方法进行表型鉴定,抗菌药敏感性和表型测试,以指示β-内酰胺酶的产生。来自葡萄球菌属。分离出的细菌中,89%(98/110)对奥沙西林耐药,39%(52/133)的肠杆菌科细菌是超广谱β-内酰胺酶的生产者,铜绿假单胞菌的57.5%(23/40)是AmpCβ-内酰胺酶和81%(30/37)的不动杆菌属对碳青霉烯类有抗性。在研究的临床变量中,发现碳青霉烯类药物的使用与对这些抗生素有抗性的细菌的定殖之间存在显着的统计学联系。这些高指标反映了当前高耐药菌生长的流行病学趋势,因此必须实施监视措施,隔离和合理使用抗生素,以最大程度地减少这些病原体的传播。

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    Franco Mayara Maria Bastos;

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  • 年度 2017
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