EPIDEMIOLOGIA, POLIMIXINAS, PSEUDOMONAS SPP., RESISTÊNCIA AOS ANTIMICROBIANOS
Resumo
Introdução: Pseudomonas spp. é um importante patógeno responsável por infecções hospitalares de difícil tratamento. O aumento no número de isolados resistentes aos carbapenêmicos, antimicrobianos utilizados no tratamento de infecções causadas por isolados multirresistentes (MR) aos antimicrobianos, tem levado a retomada do uso das polimixinas como último recurso terapêutico. O monitoramento das taxas de resistência aos antimicrobianos norteia as terapias empíricas, possibilitando o aprimoramento do tratamento, aumentando a chance de sucesso terapêutico e diminuindo o tempo de permanência do paciente nos hospitais. Objetivo: Determinar o perfil dos isolados clínicos de Pseudomonas spp. resistentes as polimixinas recuperados no Hospital Universitário (HU) de Londrina no período de janeiro de 2004 a dezembro de 2020. Métodos: Foram analisados dados referentes às culturas positivas para Pseudomonas spp. resistentes as polimixinas quanto ao sexo do paciente, tipo de amostra biológica, setor de internação e perfil de sensibilidade aos antimicrobianos. Apenas uma amostra por paciente foi incluída no estudo e foram utilizados os dados somente do primeiro isolamento. Resultados: Um total de 66 isolados foram incluídos no estudo. A maioria dos isolados (74,2%) foram recuperados de pacientes do sexo masculino internados nas Unidades de Tratamento Intensivo (43,9%), Enfermaria Masculina (16,7%) e Unidades de Tratamento de Queimados (9,1%). Urina (51,5%), secreções do trato respiratório (19,7%) e tecido (7,6%) foram às amostras clínicas com maior frequência de isolamento destes microrganismos. Do total de isolados, 34,8% foram classificados como MR e 59,1% como extensivamente resistente (ER) aos antimicrobianos. Taxas elevadas de resistência foram verificadas para os carbapenêmicos (84,8% - Imipenem/65,2% - Meropenem), fluoroquinolonas (81,8% - Ciprofloxacin), cefalosporinas (80,3% - Ceftazidima/72,7% - Cefepime), aminoglicosídeos (83,3% - Gentamicina/81,8% - Amicacina) e polimixinas (43,9% - Polimixina B/68,2% - Colistina). Discussão: As altas taxas de resistência observadas demonstram as limitações terapêuticas em infecções causadas por Pseudomonas spp. no HU, enfatizando a importância do monitoramento, adequação de medidas efetivas de controle de infecção, bem como a necessidade de programas stewardship para o uso racional dos antimicrobianos.
Publicado
2021-06-11
Como Citar
Fávaro, L. D. S., Paula-Petroli, S. B. D. ., Radoski, R. E., Carrara-Marroni, F. E. ., & Venâncio, E. J. . (2021). MONITORAMENTO DE ISOLADOS DE PSEUDOMONAS SPP. RESISTENTES ÀS POLIMIXINAS RECUPERADOS NO HOSPITAL UNIVERSITÁRIO DE LONDRINA. Revista Multidisciplinar Em Saúde, 2(2), 10. https://doi.org/10.51161/rems/1167
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