Ventilator-associated pneumonia: incidence, microbial etiology and antimicrobial resistance profile

Detalhes bibliográficos
Autor(a) principal: Alvares, Flávia Allegretti
Data de Publicação: 2022
Outros Autores: de Oliveira, Carla Sakuma, Alves, Débora Cristina Ignácio, Braun, Graziela
Tipo de documento: Artigo
Idioma: eng
por
Título da fonte: Revista de Epidemiologia e Controle de Infecção
Texto Completo: https://online.unisc.br/seer/index.php/epidemiologia/article/view/16781
Resumo: Background and Objectives: Infections caused by multi-drug resistant microorganisms have a great clinical and economic impact. The present study proposed to determine and assess ventilator-associated pneumonia (VAP) incidence in an Intensive Care Unit (ICU), to establish the profile of hospitalized patients and to determine the frequency of microorganisms isolated as well as their antimicrobial resistance profile. Methods:  A descriptive, documental study, with a quantitative approach, carried out at a teaching hospital. Participants were all individuals admitted to the General ICU who developed VAP in 2018 and 2019. Results: During the study, 146 patients were diagnosed with VAP, with an incidence of 23.66/1000 patient-days on mechanical ventilation. The median age of patients was 52.5 years and most of them were man. One hundred and eight microorganisms were isolated in cultures, the majority being gram-negative bacteria. Non-fermenting bacteria were the most frequent (n=46; 42.6%), followed by enterobacteria (n=42; 38.9%). Staphylococcus aureus was the most frequent microorganism among gram-positive (n=17; 15.7%). The most frequent multi-drug resistant bacteria were Acinetobacter baumannii and Enterobacter spp. No microorganism showed colistin and vancomycin resistance. Patients infected with multidrug-resistant bacteria were hospitalized longer when compared to other patients. Conclusions: VAP incidence was high. The knowledge of the etiologic agents of VAP and their antimicrobial resistance profile is fundamental to support the elaboration of institutional treatment protocols as well as assist in empirical antibiotic therapy.
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spelling Ventilator-associated pneumonia: incidence, microbial etiology and antimicrobial resistance profileNeumonía asociada a la ventilación mecánica: incidencia, etiología microbiana y perfil de resistencia a los antimicrobianosPneumonia associada à ventilação mecânica: incidência, etiologia microbiana e perfil de resistência aos antimicrobianosInfecção hospitalarPneumonia associada à ventilação mecânicaResistência bacteriana a drogas.Background and Objectives: Infections caused by multi-drug resistant microorganisms have a great clinical and economic impact. The present study proposed to determine and assess ventilator-associated pneumonia (VAP) incidence in an Intensive Care Unit (ICU), to establish the profile of hospitalized patients and to determine the frequency of microorganisms isolated as well as their antimicrobial resistance profile. Methods:  A descriptive, documental study, with a quantitative approach, carried out at a teaching hospital. Participants were all individuals admitted to the General ICU who developed VAP in 2018 and 2019. Results: During the study, 146 patients were diagnosed with VAP, with an incidence of 23.66/1000 patient-days on mechanical ventilation. The median age of patients was 52.5 years and most of them were man. One hundred and eight microorganisms were isolated in cultures, the majority being gram-negative bacteria. Non-fermenting bacteria were the most frequent (n=46; 42.6%), followed by enterobacteria (n=42; 38.9%). Staphylococcus aureus was the most frequent microorganism among gram-positive (n=17; 15.7%). The most frequent multi-drug resistant bacteria were Acinetobacter baumannii and Enterobacter spp. No microorganism showed colistin and vancomycin resistance. Patients infected with multidrug-resistant bacteria were hospitalized longer when compared to other patients. Conclusions: VAP incidence was high. The knowledge of the etiologic agents of VAP and their antimicrobial resistance profile is fundamental to support the elaboration of institutional treatment protocols as well as assist in empirical antibiotic therapy.Justificación y Objetivos: Las infecciones causadas por microorganismos multirresistentes tienen un gran impacto clínico y económico. El presente estudio propuso determinar y evaluar la incidencia de neumonía asociada a la ventilación mecánica (NAV); establecer el perfil de los pacientes hospitalizados; y determinar la frecuencia de microorganismos aislados y su perfil de resistencia a los antimicrobianos. Métodos: Estudio descriptivo, documental, de enfoque cuantitativo, realizado en un hospital universitario con todos los pacientes que ingresaron en la Unidad de Cuidados Intensivos (UCI) General y desarrollaron NAV en 2018 y 2019. Resultados: Durante el período de estudio, 146 pacientes fueron diagnosticados de NAV, con una incidencia de 23,66/1000 pacientes-día en ventilación mecánica. La mediana de edad de los pacientes fue de 52,5 años, con predominio del sexo masculino. Un total de 108 microorganismos fueron aislados en cultivo, representados en su mayoría por bacterias gram negativas. Las bacterias no fermentadoras fueron las más frecuentes (n=46; 42,6%), seguido de las enterobacterias (n=42; 38,9%). Entre las gram positivas, Staphylococcus aureus fue la más frecuente (n=17; 15,7%). Las bacterias multirresistentes más frecuentes fueron Acinetobacter baumannii y Enterobacter spp. Ningún microorganismo mostró resistencia a la colistina y la vancomicina. Los pacientes infectados con bacterias multirresistentes estuvieron hospitalizados durante más tiempo en comparación con otros pacientes. Conclusión: La incidencia de NAV fue alta. El conocimiento de los agentes etiológicos de la NAV y su perfil de resistencia a los antimicrobianos es fundamental para elaborar protocolos de tratamiento institucional, así como ayudar en la antibioticoterapia empírica.Justificativa e Objetivos: Infecções causadas por microrganismos multirresistentes acarretam um grande impacto clínico e econômico. O presente estudo propôs determinar e avaliar a incidência de pneumonia associada à ventilação mecânica (PAV), estabelecer o perfil dos pacientes internados e determinar a frequência dos microrganismos isolados, bem como seu perfil de resistência aos antimicrobianos. Métodos: Estudo descritivo, documental, com abordagem quantitativa, realizado em um hospital escola com todos os indivíduos internados na Unidade de Terapia Intensiva (UTI) Geral que desenvolveram PAV nos anos de 2018 e 2019. Resultados: No estudo, 146 pacientes tiveram o diagnóstico de PAV, com uma incidência de 23,66/1000 pacientes-dia em ventilação mecânica. A mediana de idade dos pacientes foi 52,5 anos, com predominância do sexo masculino. Um total de 108 microrganismos foram isolados em culturas, sendo a maioria bactérias Gram-negativas. As bactérias não fermentadoras foram as mais frequentes (n=46; 42,6%), seguidas pelas enterobactérias (n=42; 38,9%). Entre as Gram-positivas, Staphylococcus aureus foi a mais frequente (n=17; 15,7%). As bactérias multirresistentes mais frequentes foram Acinetobacter baumannii e Enterobacter spp. Nenhum microrganismo apresentou resistência à colistina e à vancomicina. Os pacientes infectados com bactérias multirresistentes ficaram mais tempo hospitalizados, quando comparados aos demais pacientes. Conclusão: A incidência de PAV foi elevada. O conhecimento dos agentes etiológicos das PAV e seu perfil de resistência aos antimicrobianos é fundamental para embasar a elaboração dos protocolos institucionais de tratamento, bem como auxiliar na antibioticoterapia empírica.Unisc2022-03-29info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://online.unisc.br/seer/index.php/epidemiologia/article/view/1678110.17058/reci.v11i4.16781Revista de Epidemiologia e Controle de Infecção; Vol. 11 No. 4 (2021)Revista de Epidemiologia e Controle de Infecção; v. 11 n. 4 (2021)2238-3360reponame:Revista de Epidemiologia e Controle de Infecçãoinstname:Universidade de Santa Cruz do Sul (UNISC)instacron:UNISCengporhttps://online.unisc.br/seer/index.php/epidemiologia/article/view/16781/10305https://online.unisc.br/seer/index.php/epidemiologia/article/view/16781/10304Copyright (c) 2022 Flávia Allegretti Alvares, Carla Sakuma Sakuma de Oliveira, Débora Cristina Ignácio Alves, Graziela Braunhttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessAlvares, Flávia Allegrettide Oliveira, Carla SakumaAlves, Débora Cristina IgnácioBraun, Graziela2023-05-23T13:20:00Zoai:ojs.online.unisc.br:article/16781Revistahttps://online.unisc.br/seer/index.php/epidemiologia/indexONGhttp://online.unisc.br/seer/index.php/epidemiologia/oai||liapossuelo@unisc.br|| julia.kern@hotmail.com||reci.unisc@gmail.com2238-33602238-3360opendoar:2023-05-23T13:20Revista de Epidemiologia e Controle de Infecção - Universidade de Santa Cruz do Sul (UNISC)false
dc.title.none.fl_str_mv Ventilator-associated pneumonia: incidence, microbial etiology and antimicrobial resistance profile
Neumonía asociada a la ventilación mecánica: incidencia, etiología microbiana y perfil de resistencia a los antimicrobianos
Pneumonia associada à ventilação mecânica: incidência, etiologia microbiana e perfil de resistência aos antimicrobianos
title Ventilator-associated pneumonia: incidence, microbial etiology and antimicrobial resistance profile
spellingShingle Ventilator-associated pneumonia: incidence, microbial etiology and antimicrobial resistance profile
Alvares, Flávia Allegretti
Infecção hospitalar
Pneumonia associada à ventilação mecânica
Resistência bacteriana a drogas.
title_short Ventilator-associated pneumonia: incidence, microbial etiology and antimicrobial resistance profile
title_full Ventilator-associated pneumonia: incidence, microbial etiology and antimicrobial resistance profile
title_fullStr Ventilator-associated pneumonia: incidence, microbial etiology and antimicrobial resistance profile
title_full_unstemmed Ventilator-associated pneumonia: incidence, microbial etiology and antimicrobial resistance profile
title_sort Ventilator-associated pneumonia: incidence, microbial etiology and antimicrobial resistance profile
author Alvares, Flávia Allegretti
author_facet Alvares, Flávia Allegretti
de Oliveira, Carla Sakuma
Alves, Débora Cristina Ignácio
Braun, Graziela
author_role author
author2 de Oliveira, Carla Sakuma
Alves, Débora Cristina Ignácio
Braun, Graziela
author2_role author
author
author
dc.contributor.author.fl_str_mv Alvares, Flávia Allegretti
de Oliveira, Carla Sakuma
Alves, Débora Cristina Ignácio
Braun, Graziela
dc.subject.por.fl_str_mv Infecção hospitalar
Pneumonia associada à ventilação mecânica
Resistência bacteriana a drogas.
topic Infecção hospitalar
Pneumonia associada à ventilação mecânica
Resistência bacteriana a drogas.
description Background and Objectives: Infections caused by multi-drug resistant microorganisms have a great clinical and economic impact. The present study proposed to determine and assess ventilator-associated pneumonia (VAP) incidence in an Intensive Care Unit (ICU), to establish the profile of hospitalized patients and to determine the frequency of microorganisms isolated as well as their antimicrobial resistance profile. Methods:  A descriptive, documental study, with a quantitative approach, carried out at a teaching hospital. Participants were all individuals admitted to the General ICU who developed VAP in 2018 and 2019. Results: During the study, 146 patients were diagnosed with VAP, with an incidence of 23.66/1000 patient-days on mechanical ventilation. The median age of patients was 52.5 years and most of them were man. One hundred and eight microorganisms were isolated in cultures, the majority being gram-negative bacteria. Non-fermenting bacteria were the most frequent (n=46; 42.6%), followed by enterobacteria (n=42; 38.9%). Staphylococcus aureus was the most frequent microorganism among gram-positive (n=17; 15.7%). The most frequent multi-drug resistant bacteria were Acinetobacter baumannii and Enterobacter spp. No microorganism showed colistin and vancomycin resistance. Patients infected with multidrug-resistant bacteria were hospitalized longer when compared to other patients. Conclusions: VAP incidence was high. The knowledge of the etiologic agents of VAP and their antimicrobial resistance profile is fundamental to support the elaboration of institutional treatment protocols as well as assist in empirical antibiotic therapy.
publishDate 2022
dc.date.none.fl_str_mv 2022-03-29
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https://online.unisc.br/seer/index.php/epidemiologia/article/view/16781/10304
dc.rights.driver.fl_str_mv https://creativecommons.org/licenses/by/4.0
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dc.publisher.none.fl_str_mv Unisc
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dc.source.none.fl_str_mv Revista de Epidemiologia e Controle de Infecção; Vol. 11 No. 4 (2021)
Revista de Epidemiologia e Controle de Infecção; v. 11 n. 4 (2021)
2238-3360
reponame:Revista de Epidemiologia e Controle de Infecção
instname:Universidade de Santa Cruz do Sul (UNISC)
instacron:UNISC
instname_str Universidade de Santa Cruz do Sul (UNISC)
instacron_str UNISC
institution UNISC
reponame_str Revista de Epidemiologia e Controle de Infecção
collection Revista de Epidemiologia e Controle de Infecção
repository.name.fl_str_mv Revista de Epidemiologia e Controle de Infecção - Universidade de Santa Cruz do Sul (UNISC)
repository.mail.fl_str_mv ||liapossuelo@unisc.br|| julia.kern@hotmail.com||reci.unisc@gmail.com
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