Nosocomial Bloodstream Infections in Brazilian Hospitals: Analysis of 2,563 Cases from a Prospective Nationwide Surveillance Study

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Marra, Alexandre R. ^{[1, 2]} ; Aranha Camargo, Luis Fernando ^[1] ; Campos Pignatari, Antonio Carlos ^{[1, 3]} ; Sukiennik, Teresa ; Petersen Behar, Paulo Renato ^[4] ; Servolo Medeiros, Eduardo Alexandrino ^[1] ; Ribeiro, Julival ^[5] ; Girao, Evelyne ^[6] ; Correa, Luci ^[7] ; Guerra, Carla ^[8] ; Brites, Carlos ^[9] ; Pires Pereira, Carlos Alberto ^[10] ; Carneiro, Irna ; Reis, Marise ^{[11, 12]} ; de Souza, Marta Antunes ^[13] ; Tranchesi, Regina ^[3] ; Barata, Cristina U. ^[14] ; Edmond, Michael B. ^[15] ; Grp, Brazilian SCOPE Study

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^[1] Univ Fed Sao Paulo UNIFESP, Sao Paulo - Brazil

^[2] Hosp Israelita Albert Einstein, Intens Care Unit, BR-05651901 Sao Paulo - Brazil

^[3] Hosp 9 Julho, Sao Paulo - Brazil

^[4] Hosp Conceicao, Porto Alegre, RS - Brazil

^[5] Hosp Base, Brasilia, DF - Brazil

^[6] Hosp Walter Cantidio, Fortaleza, Ceara - Brazil

^[7] Hosp Rim & Hypertensao, Sao Paulo - Brazil

^[8] Hosp Diadema, Sao Paulo - Brazil

^[9] Hosp Espanhol, Salvador, BA - Brazil

^[10] Inst Oncol Pediat IOP GRAAC, Sao Paulo - Brazil

^[11] Hosp Coracao, Natal, RN - Brazil

^[12] Hosp UNIMED, Natal, RN - Brazil

^[13] Hosp Clin Goiania, Goiania, Go - Brazil

^[14] Univ Fed Triangulo Mineiro, Uberaba, MG - Brazil

^[15] Virginia Commonwealth Univ, Richmond, VA - USA

• Tipo de documento: Artigo Científico
• Fonte: Journal of Clinical Microbiology; v. 49, n. 5, p. 1866-1871, MAY 2011.
• Citações Web of Science: 105

Resumo

Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality. Data from a nationwide, concurrent surveillance study, Brazilian SCOPE (Surveillance and Control of Pathogens of Epidemiological Importance), were used to examine the epidemiology and microbiology of nBSIs at 16 Brazilian hospitals. In our study 2,563 patients with nBSIs were included from 12 June 2007 to 31 March 2010. Ninety-five percent of BSIs were monomicrobial. Gram-negative organisms caused 58.5% of these BSIs, Gram-positive organisms caused 35.4%, and fungi caused 6.1%. The most common pathogens (monomicrobial) were Staphylococcus aureus (14.0%), coagulase-negative staphylococci (CoNS) (12.6%), Klebsiella spp. (12.0%), and Acinetobacter spp. (11.4%). The crude mortality was 40.0%. Forty-nine percent of nBSIs occurred in the intensive-care unit (ICU). The most frequent underlying conditions were malignancy, in 622 patients (24.3%). Among the potential factors predisposing patients to BSI, central venous catheters were the most frequent (70.3%). Methicillin resistance was detected in 157 S. aureus isolates (43.7%). Of the Klebsiella sp. isolates, 54.9% were resistant to third-generation cephalosporins. Of the Acinetobacter spp. and Pseudomonas aeruginosa isolates, 55.9% and 36.8%, respectively, were resistant to imipenem. In our multicenter study, we found high crude mortality and a high proportion of nBSIs due to antibiotic-resistant organisms. (AU)

• Processo FAPESP: 06/57700-0 - Projeto brazilian scope (surveillance and control of pathogens of epidemiological importance).
• Beneficiário: Antonio Carlos Campos Pignatari
• Modalidade de apoio: Auxílio à Pesquisa - Regular