EVOLUÇÃO DA RESISTÊNCIA E ASPECTOS MICROBIOLÓGICOS DE Pseudomonas aeruginosa e Acinetobacter baumannii EM UNIDADES DE TERAPIA INTENSIVA

Abstract

The increase in bacterial resistance occurs in all regions of the world, especially in critically ill patients hospitalized in intensive care units (ICUs) and that make use of several antimicrobials. Bacterial resistance complicates therapy prolongs the ICU stay and increased morbidity and mortality. Among the microorganisms that cause infections in ICUs, we highlight P. aeruginosa and A. baumannii, gram-negative high incidence of nosocomial infections and have shown a tendency to increased antimicrobial resistance. OBJECTIVE: To evaluate microbial and bacterial resistance in adult intensive care agents P. aeruginosa and A. baumannii. MATERIALS AND METHODS: Retrospective study from January 2007 to December 2010 on the sensitivity and P. aeruginosa and A. baumannii in adult ICU patients (medical and surgical) of HC / UFG, with a diagnosis of hospital infection. We analyzed the evolution of resistance, antimicrobial consumption, mortality, topography of infections and length of stay in the units. 121 cases have been cataloged. RESULTS: The mean age of patients was 51.2 ± 17.9 years, male 45.45% and 55.55% female, mean ICU stay was 26.99 days, compared with 6.22 days of the general population unit. The mortality rate was 37.19% compared to a rate of 27.17% of the population. The primary site of infection was the respiratory tract with 41.3% followed by infection of the bloodstream with 27.27%. The initial average of bacterial resistance related of P. aeruginosa was close to 50% and A. baumannii was greater than 80%, with no significant modifications to the P. aeruginosa in this period. There was a significant increase in resistance to A. baumannii to amikacin. Consumption of antimicrobial agents showed an increase of antimicrobials amikacin, imipenem and piperacillin-tazobactam in cases of infection by P. aeruginosa infections and imipenem in A. baumannii. No correlation was found between bacterial resistance and antimicrobial consumption. CONCLUSION: Mortality and length of stay were higher in the study group. The bloodstream and respiratory tract were the main sites of infection by A. baumannii and P. aeruginosa multiresistant. The susceptibility profile revealed that P. aeruginosa and A. baumannii are highly resistant to antimicrobials. There were no significant changes in the evolution of antimicrobial resistance to the antibiotics tested, except for amikacin used in infections caused by A. baumannii. The consumption of antimicrobials showed increased consumption of amikacin, imipenem and piperacillin-tazobactam in patients infected with P. aeruginosa and to A. baumannii increased consumption was only to imipenem. The relationship between consumption of antimicrobials and increased bacterial resistance was not identified.