Fatores de risco para acinetobacter baumannii em isolados de pacientes em uma unidade de terapia intensiva de um hospital público do Paraná
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações do UNIOESTE |
Texto Completo: | https://tede.unioeste.br/handle/tede/5980 |
Resumo: | Acinetobacter baumannii (A. baumannii) is an opportunistic pathogen that has caused outbreaks of global infections and an increasing profile of antimicrobial resistance. Objective: To identify risk factors for A. baumannii infection in isolated patients hospitalized in an Intensive Care Unit (ICU) of a tertiary public hospital in Paraná, Brazil. Material and Methods: A retrospective paired case-control study (ratio 1: 2) was conducted from January 2018 to December 2020. Patients in the case group admitted to the ICU with A. baumanni (n=68 cases) were compared with patients in the control group without Infection by A. baumannii (n=136) matched by age (±10years), sex, ICU stay (±5 days). Conditional multiple logistic regression was used to determine statistically significant risk factors based on the results of bivariate analyses. Results: Mortality was higher in infected (cases) than in non-infected patients (51.5% vs. 39.7%). The incidence and bacterial resistance increased annually. At bivariate analysis, cases had longer hospital stays (median 35 vs. 22 p<0.001) and longer remained in the ICU (median 23 vs. 16, p<0.001). A long time of use of a central venous catheter (median 25 vs. 18, p>0.001), the vesical catheter (median 29 vs. 20, p<0.001), and mechanical ventilation (median 17 vs. 12, p<0.001). Cases also presented a higher frequency of admission by transfer from another unit (p<0.001) previous hospitalization (p=0.011), colonization (p<0.001), surgical procedure (p=0.013), and use of an enteral tube (p=0.011) than controls. The multivariate analysis showed that hospitalization time (OR=1.06; CI95%:(1.03-1.08), transfer from another unit (OR=5.03; CI95% 2.30-10.98) and colonization (OR= 9.32; CI95% 3.52-24.72) were independently associated with infection. Conclusions: We showed an increase in Infections by A. baumannii and antimicrobial resistance, need for surveillance, and constant evaluation of control actions. Risk factors were colonization, previous hospitalization, and hospitalization time. Knowing them is essential for the decision-making of professionals and optimization of prevention, control, and therapeutic management actions. |
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Ferreto, Lirane Elize Defantehttp://lattes.cnpq.br/5828944409163245Ferreto, Lirane Elize Defantehttp://lattes.cnpq.br/5828944409163245Martins, Cleide Viviane Buzanellohttp://lattes.cnpq.br/0380880522220338Fortes, Paulo Cezar Nuneshttp://lattes.cnpq.br/3910426358531116http://lattes.cnpq.br/1742289391799533Silva, Mirian Carla Bortolamedi da2022-04-28T18:29:49Z2022-02-22SILVA, Mirian Carla Bortolamedi da. Fatores de risco para acinetobacter baumannii em isolados de pacientes em uma unidade de terapia intensiva de um hospital público do Paraná. 2022. 128 f. Dissertação (Mestrado em Ciências Aplicadas à Saúde) - Universidade Estadual do Oeste do Paraná, Francisco Beltrão, 2022.https://tede.unioeste.br/handle/tede/5980Acinetobacter baumannii (A. baumannii) is an opportunistic pathogen that has caused outbreaks of global infections and an increasing profile of antimicrobial resistance. Objective: To identify risk factors for A. baumannii infection in isolated patients hospitalized in an Intensive Care Unit (ICU) of a tertiary public hospital in Paraná, Brazil. Material and Methods: A retrospective paired case-control study (ratio 1: 2) was conducted from January 2018 to December 2020. Patients in the case group admitted to the ICU with A. baumanni (n=68 cases) were compared with patients in the control group without Infection by A. baumannii (n=136) matched by age (±10years), sex, ICU stay (±5 days). Conditional multiple logistic regression was used to determine statistically significant risk factors based on the results of bivariate analyses. Results: Mortality was higher in infected (cases) than in non-infected patients (51.5% vs. 39.7%). The incidence and bacterial resistance increased annually. At bivariate analysis, cases had longer hospital stays (median 35 vs. 22 p<0.001) and longer remained in the ICU (median 23 vs. 16, p<0.001). A long time of use of a central venous catheter (median 25 vs. 18, p>0.001), the vesical catheter (median 29 vs. 20, p<0.001), and mechanical ventilation (median 17 vs. 12, p<0.001). Cases also presented a higher frequency of admission by transfer from another unit (p<0.001) previous hospitalization (p=0.011), colonization (p<0.001), surgical procedure (p=0.013), and use of an enteral tube (p=0.011) than controls. The multivariate analysis showed that hospitalization time (OR=1.06; CI95%:(1.03-1.08), transfer from another unit (OR=5.03; CI95% 2.30-10.98) and colonization (OR= 9.32; CI95% 3.52-24.72) were independently associated with infection. Conclusions: We showed an increase in Infections by A. baumannii and antimicrobial resistance, need for surveillance, and constant evaluation of control actions. Risk factors were colonization, previous hospitalization, and hospitalization time. Knowing them is essential for the decision-making of professionals and optimization of prevention, control, and therapeutic management actions.Acinetobacter Baumannii (A. Baumannii) é um patógeno oportunista que tem causado surtos de infecções globais e com crescente perfil de resistência a antimicrobianos. Objetivo: Identificar os fatores de risco para infecção por A. baumannii em isolados de pacientes internados em Unidade de Terapia Intensiva (UTI) de um hospital público terciário do Paraná, Brasil. Materiais e métodos: Um estudo caso-controle pareado retrospectivo (proporção 1: 2) foi conduzido de janeiro de 2018 a dezembro de 2020. Pacientes do grupo caso internados em UTI com A. baumanni (n=68 casos) foram comparados com pacientes do grupo controle sem infecção por A. baumannii (n=136) pareados por idade (±10 anos), sexo, tempo de internação em UTI (±5 dias). A regressão logística múltipla condicional foi usada para determinar os fatores de risco estatisticamente significativos com base nos resultados das análises bivariadas. Resultados: Mortalidade foi maior em infectados (casos), que em não-infectados (51,5% vs. 39,7%). A incidência e a resistência bacteriana aumentaram anualmente. Á análise bivariada, casos apresentaram maior tempo de internação hospitalar (mediana 35 vs. 22 p<0,001) e maior permanecia em UTI (mediana 23 vs. 16, p<0,001). Maior tempo de uso de cateter venoso central (mediana 25 vs. 18, p>0,001), sonda vesical de demora (mediana 29 vs. 20, p<0,001) e ventilação mecânica (mediana 17 vs. 12, p<0,001). Casos também apresentaram maior frequência de admissão por transferência de outra unidade (p<0,001) internação prévia (p=0,011), colonização (p<0,001), realização de procedimento cirúrgico (p=0,013) e uso de sonda enteral (p=0,011) que controles. A análise multivariada mostrou que tempo de internação (OR=1.06; IC95%:(1,03-1,08), transferência de outra unidade (OR=5,03; IC95% 2,30-10,98) e colonização (OR= 9,32; IC95% 3,52-24,72) foram independentemente associadas à infecção Conclusão: Evidenciamos um aumento de Infecções por A. baumannii e resistência antimicrobiana, necessidade de vigilância e avaliação constante das ações de controle. Fatores de risco foram colonização, internação prévia e tempo de internação. Conhecê-los é essencial para a tomada de decisão dos profissionais e otimização das ações de prevenção, controle e manejo terapêutico.Submitted by Almir Squinsani (almir.squinsani@unioeste.br) on 2022-04-28T18:29:49Z No. of bitstreams: 2 Mirian_Silva_2022.pdf: 3742496 bytes, checksum: 6dffde3327859499c2f449a32efe6239 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2022-04-28T18:29:49Z (GMT). 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dc.title.por.fl_str_mv |
Fatores de risco para acinetobacter baumannii em isolados de pacientes em uma unidade de terapia intensiva de um hospital público do Paraná |
dc.title.alternative.eng.fl_str_mv |
Risk factors associated with Acinetobacter baumannii infections in patients' isolated in an Intensive Care Unit of a Public Hospital in Paraná |
title |
Fatores de risco para acinetobacter baumannii em isolados de pacientes em uma unidade de terapia intensiva de um hospital público do Paraná |
spellingShingle |
Fatores de risco para acinetobacter baumannii em isolados de pacientes em uma unidade de terapia intensiva de um hospital público do Paraná Silva, Mirian Carla Bortolamedi da Acinetobacter baumannii Fatores de risco Infecção Terapia intensiva Acinetobacter baumannii Risk-factors; Infection Intensive care CIÊNCIAS DA SAÚDE |
title_short |
Fatores de risco para acinetobacter baumannii em isolados de pacientes em uma unidade de terapia intensiva de um hospital público do Paraná |
title_full |
Fatores de risco para acinetobacter baumannii em isolados de pacientes em uma unidade de terapia intensiva de um hospital público do Paraná |
title_fullStr |
Fatores de risco para acinetobacter baumannii em isolados de pacientes em uma unidade de terapia intensiva de um hospital público do Paraná |
title_full_unstemmed |
Fatores de risco para acinetobacter baumannii em isolados de pacientes em uma unidade de terapia intensiva de um hospital público do Paraná |
title_sort |
Fatores de risco para acinetobacter baumannii em isolados de pacientes em uma unidade de terapia intensiva de um hospital público do Paraná |
author |
Silva, Mirian Carla Bortolamedi da |
author_facet |
Silva, Mirian Carla Bortolamedi da |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Ferreto, Lirane Elize Defante |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/5828944409163245 |
dc.contributor.referee1.fl_str_mv |
Ferreto, Lirane Elize Defante |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/5828944409163245 |
dc.contributor.referee2.fl_str_mv |
Martins, Cleide Viviane Buzanello |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/0380880522220338 |
dc.contributor.referee3.fl_str_mv |
Fortes, Paulo Cezar Nunes |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/3910426358531116 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/1742289391799533 |
dc.contributor.author.fl_str_mv |
Silva, Mirian Carla Bortolamedi da |
contributor_str_mv |
Ferreto, Lirane Elize Defante Ferreto, Lirane Elize Defante Martins, Cleide Viviane Buzanello Fortes, Paulo Cezar Nunes |
dc.subject.por.fl_str_mv |
Acinetobacter baumannii Fatores de risco Infecção Terapia intensiva |
topic |
Acinetobacter baumannii Fatores de risco Infecção Terapia intensiva Acinetobacter baumannii Risk-factors; Infection Intensive care CIÊNCIAS DA SAÚDE |
dc.subject.eng.fl_str_mv |
Acinetobacter baumannii Risk-factors; Infection Intensive care |
dc.subject.cnpq.fl_str_mv |
CIÊNCIAS DA SAÚDE |
description |
Acinetobacter baumannii (A. baumannii) is an opportunistic pathogen that has caused outbreaks of global infections and an increasing profile of antimicrobial resistance. Objective: To identify risk factors for A. baumannii infection in isolated patients hospitalized in an Intensive Care Unit (ICU) of a tertiary public hospital in Paraná, Brazil. Material and Methods: A retrospective paired case-control study (ratio 1: 2) was conducted from January 2018 to December 2020. Patients in the case group admitted to the ICU with A. baumanni (n=68 cases) were compared with patients in the control group without Infection by A. baumannii (n=136) matched by age (±10years), sex, ICU stay (±5 days). Conditional multiple logistic regression was used to determine statistically significant risk factors based on the results of bivariate analyses. Results: Mortality was higher in infected (cases) than in non-infected patients (51.5% vs. 39.7%). The incidence and bacterial resistance increased annually. At bivariate analysis, cases had longer hospital stays (median 35 vs. 22 p<0.001) and longer remained in the ICU (median 23 vs. 16, p<0.001). A long time of use of a central venous catheter (median 25 vs. 18, p>0.001), the vesical catheter (median 29 vs. 20, p<0.001), and mechanical ventilation (median 17 vs. 12, p<0.001). Cases also presented a higher frequency of admission by transfer from another unit (p<0.001) previous hospitalization (p=0.011), colonization (p<0.001), surgical procedure (p=0.013), and use of an enteral tube (p=0.011) than controls. The multivariate analysis showed that hospitalization time (OR=1.06; CI95%:(1.03-1.08), transfer from another unit (OR=5.03; CI95% 2.30-10.98) and colonization (OR= 9.32; CI95% 3.52-24.72) were independently associated with infection. Conclusions: We showed an increase in Infections by A. baumannii and antimicrobial resistance, need for surveillance, and constant evaluation of control actions. Risk factors were colonization, previous hospitalization, and hospitalization time. Knowing them is essential for the decision-making of professionals and optimization of prevention, control, and therapeutic management actions. |
publishDate |
2022 |
dc.date.accessioned.fl_str_mv |
2022-04-28T18:29:49Z |
dc.date.issued.fl_str_mv |
2022-02-22 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
SILVA, Mirian Carla Bortolamedi da. Fatores de risco para acinetobacter baumannii em isolados de pacientes em uma unidade de terapia intensiva de um hospital público do Paraná. 2022. 128 f. Dissertação (Mestrado em Ciências Aplicadas à Saúde) - Universidade Estadual do Oeste do Paraná, Francisco Beltrão, 2022. |
dc.identifier.uri.fl_str_mv |
https://tede.unioeste.br/handle/tede/5980 |
identifier_str_mv |
SILVA, Mirian Carla Bortolamedi da. Fatores de risco para acinetobacter baumannii em isolados de pacientes em uma unidade de terapia intensiva de um hospital público do Paraná. 2022. 128 f. Dissertação (Mestrado em Ciências Aplicadas à Saúde) - Universidade Estadual do Oeste do Paraná, Francisco Beltrão, 2022. |
url |
https://tede.unioeste.br/handle/tede/5980 |
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por |
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por |
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http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
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http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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openAccess |
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dc.publisher.none.fl_str_mv |
Universidade Estadual do Oeste do Paraná Francisco Beltrão |
dc.publisher.program.fl_str_mv |
Programa de Pós-Graduação em Ciências Aplicadas à Saúde |
dc.publisher.initials.fl_str_mv |
UNIOESTE |
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Brasil |
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Centro de Ciências da Saúde |
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Universidade Estadual do Oeste do Paraná Francisco Beltrão |
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Biblioteca Digital de Teses e Dissertações do UNIOESTE |
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Biblioteca Digital de Teses e Dissertações do UNIOESTE - Universidade Estadual do Oeste do Paraná (UNIOESTE) |
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biblioteca.repositorio@unioeste.br |
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