Authors
Abstract(s)
O sangue é um líquido estéril que na presença de microrganismos pode iniciar um
processo de bacteriemia. A deteção do agente patogénico realiza-se habitualmente através
de um procedimento qualitativo que recorre à realização de culturas de sangue, designadas
de hemoculturas.
A hemocultura é uma prova analítica, na qual o sangue colhido no paciente é introduzido e
incubado em frascos contendo meio de cultura, que nos permite verificar a presença de
microrganismos. A Unidade Hospitalar de Cuidados Intensivos é um setor de elevada
complexidade pela natureza de doentes que recebe, ao qual está associado uma elevada
taxa de mortalidade. Esta área hospitalar é constituída por pacientes com um estado de
saúde muito debilitado e no qual, o risco de infecções nosocomiais é elevado. Foi realizado
um estudo retrospetivo sobre o perfil microbiológico e de resistência bacteriana em
hemoculturas da Unidade de Cuidados Intensivos da Unidade Hospitalar do Alto Minho,
no período de 2005 a 2009, no laboratório de Microbiologia. Foram analisadas 125
amostras de pacientes com hemoculturas positivas, das quais 89 sujeitos eram do sexo
masculino com idade média de 59.9 anos; e 36 sujeitos do sexo feminino com idade media
de 68,6 anos. Relativamente ao grupo microbiológico, verificou-se uma maior prevalência
de Staphylococcus coagulase negativa, tendo-se registado 31 casos de Staphylococcus
epidermidis, 11 casos de Staphylococcus haemolyticus e 15 casos de Staphylococcus
hominis; no grupo dos Streptococcus spp registaram-se 6 casos de Enterococcus faecalis e
de 9 casos de Streptococcus pneumoniae; no grupo dos bacilos Gram-negativos oxidase
negativa observaram-se 5 casos de Escherichia coli e 2 casos de Serratia marcescens. A
menor prevalência foi observada para os bacilos Gram-negativos oxidase positiva,
registando-se 7 casos de Pseudomonas aeruginosa e 3 casos de Acinetobacter baumannii.
Em relação ao perfil de resistência e sensibilidade, nos microrganismos Gram-positivos, os
Staphylococcus coagulase negativa apresentaram-se todos sensíveis à vancomicina, 100%
resistentes à penicilina e 80% resistentes à oxacilina; os Staphylococcus aureus
apresentaram-se todos sensíveis à vancomicina, todos resistentes à penicilina e
aproximadamente 60% resistentes à oxacilina; os Streptococcus spp foram todos sensíveis
à vancomicina e os Enterococcus spp 20% resistentes a este mesmo antibiótico. Nos
microrganismos Gram-negativos mostraram-se 25 a 30% resistentes à ciprofloxacina,
gentamicina e imipenem e os bacilos Gram-negativos oxidase negativa apresentaram
resistência ao cefotaxime superior a 65%.
A ULSAM é constituída por uma Comissão de Controlo de Infeção que
continuamente implementa programas de controlo, contudo face aos resultados
apresentados e à realidade das infeções hospitalares, constitui um desafio diário aperfeiçoar
e incrementar medidas que atendam cada vez mais a esta problemática.
The blood is a sterile liquid that in the presence of microorganisms may initiates a process of bacteremia. The detection of the pathogen is generally performed by a qualitative procedure using blood culture. This procedure is an analytical test, in which the blood specimen is introduced and incubated into bottles with culture medium and allows to verify the presence of microorganisms. The Hospital Intensive Care Unit is a sector highly complex due to the nature of patients they receive which is associated with a high mortality rate. This area comprises hospital patients with severely compromised state of health and in which the risk of nosocomial infections is very high. So, the objective of this work was to establish a retrospective study of blood cultures on the Intensive Care Unit, of Alto Minho Hospitalar Unit, in the period of 2005 to 2009, based on the results of the microbiology laboratory. We analyzed 125 samples from patients with positive blood cultures, of which 89 subjects were male with an average age of 59.9 years and 36 female subjects with an average age of 68.6 years. Concerning the isolated microorganisms, there was a greater prevalence of coagulase negative Staphylococci, being recorded 31 cases of Staphylococcus epidermidis, 11 cases of Staphylococcus haemolyticus and 15 cases of Staphylococcus hominis; in the group of Streptococcus spp there was 6 cases Enterococcus faecalis and 9 cases of Streptococcus pneumoniae; the group of oxidase negative Gram-negative bacilli 5 cases of Escherichia coli and 2 cases of Serratia marcescens were observed. The lowest prevalence was obtained for oxidase positive Gram-negative bacilli, 7 cases of Pseudomonas aeruginosa and 3 cases of Acinetobacter baumannii. Regarding the profile of antibiotic sensitivity, all Gram-positive microorganisms were sensitive to vancomycin and oxacillin-resistant, while Gram-negative showed up 25 to 30% resistance to ciprofloxacin, gentamicin and imipenem and above 65% of Gram-negative bacilli oxidase negative were resistant to cefotaxime. ULSAM consists of an Infection Control Committee that continuously implements surveillance programmes to reduce the nosocomial infections, however given the results and facing the reality of hospital infections, is a daily challenge to improve and enhance measures to solve this increasingly problematic is a daily challenge.
The blood is a sterile liquid that in the presence of microorganisms may initiates a process of bacteremia. The detection of the pathogen is generally performed by a qualitative procedure using blood culture. This procedure is an analytical test, in which the blood specimen is introduced and incubated into bottles with culture medium and allows to verify the presence of microorganisms. The Hospital Intensive Care Unit is a sector highly complex due to the nature of patients they receive which is associated with a high mortality rate. This area comprises hospital patients with severely compromised state of health and in which the risk of nosocomial infections is very high. So, the objective of this work was to establish a retrospective study of blood cultures on the Intensive Care Unit, of Alto Minho Hospitalar Unit, in the period of 2005 to 2009, based on the results of the microbiology laboratory. We analyzed 125 samples from patients with positive blood cultures, of which 89 subjects were male with an average age of 59.9 years and 36 female subjects with an average age of 68.6 years. Concerning the isolated microorganisms, there was a greater prevalence of coagulase negative Staphylococci, being recorded 31 cases of Staphylococcus epidermidis, 11 cases of Staphylococcus haemolyticus and 15 cases of Staphylococcus hominis; in the group of Streptococcus spp there was 6 cases Enterococcus faecalis and 9 cases of Streptococcus pneumoniae; the group of oxidase negative Gram-negative bacilli 5 cases of Escherichia coli and 2 cases of Serratia marcescens were observed. The lowest prevalence was obtained for oxidase positive Gram-negative bacilli, 7 cases of Pseudomonas aeruginosa and 3 cases of Acinetobacter baumannii. Regarding the profile of antibiotic sensitivity, all Gram-positive microorganisms were sensitive to vancomycin and oxacillin-resistant, while Gram-negative showed up 25 to 30% resistance to ciprofloxacin, gentamicin and imipenem and above 65% of Gram-negative bacilli oxidase negative were resistant to cefotaxime. ULSAM consists of an Infection Control Committee that continuously implements surveillance programmes to reduce the nosocomial infections, however given the results and facing the reality of hospital infections, is a daily challenge to improve and enhance measures to solve this increasingly problematic is a daily challenge.