Incidência bacteriana e perfil de resistência a antimicrobianos em pacientes pediátricos de um hospital público de Rondônia, Brasil

As infeccoes de maiores preocupacoes dos profissionais da area de saude sao as que ocorrem nas unidades que atendem pacientes mais suscetiveis a infeccao - Pediatria, Unidades de Terapia Intensiva (UTI) e Unidades Oncologicas. Dentre os fatores contribuintes para altas taxas de infeccoes e mortalidade estao: gravidade da doenca, procedimentos que requerem mais tempo e os invasivos, e longos periodos de internacao. Foi realizado um estudo de carater retrospectivo, transversal, nao controlado nas unidades pediatricas – Clinicas Pediatricas, UTI Pediatrica e Oncopediatria de um hospital publico do Estado de Rondonia, Brasil. Ponderando-se o levantamento dos resultados de culturas e antibiogramas isolados nas unidades pediatricas do hospital, no periodo de janeiro a julho de 2010, foram analisados 313 antibiogramas. Destes, 19,2% apresentaram crescimento bacteriano, dos quais a maior parte (38%) foram Hemoculturas. Os microrganismos mais comumente encontrados foram os Bacilos Nao Fermentadores (BNF) (28,3%), Escherichia coli(25%) e Enterobacter spp. (20%). Algumas cepas chamam a atencao com relacao ao aparecimento de resistencia, como as cepas de Pseudomonas aeruginosa, cuja resistencia as cefalosporinas de terceira geracao foi analisada em mais de 90% e as cepas de Enterobacter spp., que apresentaram resistencia aos carbapenemicos. A ala da Oncopediatria mostrou-se a menos afetada com relacao as outras, pois apenas 4% das amostras coletadas para exame microbiologico obtiveram crescimento bacteriano, ja em pacientes da UTI Pediatrica houve crescimento bacteriano em 29,2%. Para evitar o crescimento da resistencia dos microrganismos e o uso empirico e indiscriminado de antimicrobianos e necessaria uma avaliacao do perfil de resistencia bacteriana que norteie a prescricao racional e adequada destes farmacos. Palavras-Chave: Pediatria. Resistencia Microbiana a Medicamentos. Infeccao Hospitalar.

 ABSTRACT 

Bacterial incidence and resistance profile against the antibiotics in pediatric patients at a public hospital in Rondonia, Brazil

 The most worrying infections for health professionals are those that occur in hospital units that treat patients particularly susceptible to infection - Pediatrics, Intensive Care Unit (ICU) and Oncology Units. The factors that contribute to high rates of infection and mortality are: severity of the disease, procedures that require more time and / or are invasive and long periods of hospitalization. We conducted a retrospective, cross- sectional, uncontrolled study in the pediatric units - Pediatric Clinic, Pediatric ICU and Pediatric Oncology - in a public hospital in Rondonia, a state of Brazil. Taking into account the survey results of cultures and antibiograms of isolates taken in pediatric hospital units in the period from January to July 2010, 313 antibiograms were analyzed. Of these, 19.2% had bacterial growth, of which the majority (38%) were blood cultures. The microorganisms most commonly found were non- fermentative bacilli (28.3%), Escherichia coli (25%) and Enterobacter spp. (20%). Some strains of bacteria gave cause for concern, due to the development of resistance, such as strains of Pseudomonas aeruginosa , more than 90% of which exhibited resistance to third generation cephalosporins, and the strain of Enterobacter spp., which showed resistance to carbapenems. The unit of pediatric oncology proved to be the least affected of the three, since only 4% of the strains isolated there showed bacterial growth, while in the ICU the bacterial growth was found in 29.2% of the exams. To prevent the increasing resistance of microorganisms found in this hospital and the empirical and indiscriminate use of antibiotics, it will be necessary to assess the bacterial resistance profile, to guide rational and appropriate prescribing of these drugs. Keywords : Pediatrics. Drug Resistance. Microbial. Cross Infection