Infecções por corinebactérias não diftéricas em cateter venoso central de pacientes oncológicos pediátricos

• Autor(a) principal: Carvalho, Ricardo Vianna de
• Data de Publicação: 2015
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/8757
• topic: Câncer; Corynebacterium; Bacteremia; Pediatric câncer; Venous cateter; Antimicrobial resistance; Câncer; Corynebacterium; Bbacteremia; Câncer pediátrico; Cateter venoso; Resistência a antimicrobianos; Infecções por corynebacterium Fisiopatologia; Infecções Relacionadas a Cateter; Tumores em crianças; Infecção em crianças; Bacteremia Fisiopatologia; Resistência Microbiana a Medicamentos; CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::CANCEROLOGIA

Retrospective descriptive study conducted at the National Cancer Institute José Alencar Gomes da Silva, INCA / HCI- Rio de Janeiro, Brazil, (INCA- HCI- RJ) investigated the Corynebacterium infections on pediatric patients under treatement in pediatric onco hematology departments and their venous access. The results allowed the development of two articles. The Article 1 - Bacteremia caused by of non-diphtheric corynebacteria were analysed in two periods, seven years apart (2003/2004 and 2012/2013), including 62 patients. The Article 2 - Investigations of Corynebacterium sp. infections in 24 cases of children under 18 years in pediatric onco-hematologycal treatment, in catheter blood samples and / or peripheral were carried out with clinical and epidemiological aspects, in two periods with an interval of eight years apart (2003/2004 and 2013/2014). In both studies the clinical and epidemiological aspects, the treatments performed, the management of each patient, and the evaluation of the antimicrobial susceptibility of the isolates were assessed. Solid tumours had a higher prevalence in both analyses. In the first article, corynebacterial infections were related to the central venous catheter. After these results, a second retrospective study was designed to approach the pediatric patients undergoing treatment. Approximately 83.3% of these patients used long-term venous catheter (LTCVC). In both studies C. amycolatum was the predominant species. The prevalence of new species of corynebacteria was observed, including some multi-drug resistant species. In addition to the development of antimicrobial susceptibility patterns, microbiological analysis showed rising resistance of these microorganisms to antibiotics used in the routine treatment for infections by this oncological group. Although we have been identified multidrug-resistant strains, all isolates presented susceptibility to vancomycin (Articles 1 and 2). The use of vancomycin allowed the preservation of venous catheters and clinical stabilization in most cases. In the second study, 40% of LTCVC were preserved. The comparative analysis of the periods studied showed an improvement in preservation of venous devices by antimicrobial treatment protocol in cases of Corynebacterium infections. All of variable factors since the multidisciplinary team assistance, the correctly clinical suspect infections cases handling of samples, identification and laboratory results as well as the treatment proposal, promoted a significant improvement of patient care and contributed to the success of therapy observed in this study. Currently, corynebacterial infections have been considered as important agents in pediatric oncology patients, the development of specific strategies could improve the protocols as well as the treatment of infections caused by these pathogens.