Infecções hospitalares do trato urinário e corrente sangüínea e fatores associados em pacientes internados em unidades de tratamento intensivo no Distrito Federal

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

Introduction: hospital-acquired infection is a public health issue because it increases morbidity, mortality and time of permanence of patients leading to higher hospitalization costs. In the health centers of Intensive Care Units (ICUs) are particularly concerned places with hospital infection due to the severity of illness and due to greater exposure of patients to risk procedures. Objective: this current study had the purpose to find out the rate of incidence of risk factors associated to infection to the urinary tract and bloodstream infection related to central venous catheter (CVC), in patients in intensive care units of public hospitals in the Federal District of Brazil. Methods: we conducted an epidemiological prospective cohort study. We used at eight ICUs belonging or associated to the Brazilian Public Health System with a sequential sample of all inpatients that stayed in ICUs for more than 24 hours. Results: from the total number of patients admitted in these units1006; 96% urinary catheters and 62.6% used CVC. An incidence of hospital-acquired UTI was 8.7% and community-acquired UTI was 6,3%. Results showed association between UTI occurrence and some specific deseases as endocrinological, respiratory, renal and orthopedic and trauma diseases). The parallel use of phlebotomy and bladder catheterization was a risk factor for UTI even after confounding control. Use of peripheral flexible venous catheters was a protective factor for UTI with statistical significance. BSI incidence was 6.4% and its occurrence was associated to hospitalization time of patients, (the average time of BSI patient was 40.3 days whereas not-infected patients was 11.5 days); the greater BSI incidence rate was found among patients with neurological conditions (30%); 62,5% of BSI patients used CVC for more than 21 days. Double lumen catheter was more often used . Gram-positive germs were the most isolated ones. Conclusion: most of the findings are consistent with medical literature even though studies were conducted at several contextual frames. Training of ICU health staff must be analyzed and our results will hopefully help to address those educational activities. Procedures standardization as well as rational antibiotic prescription are necessary because we are dealing with a hospital network within the Public Health System. We emphasize the role of active involvement of Medicine and Nursery professionals within the ICU staff teams in the prevention and surveillance of nosocomial infections.

ASSUNTO(S)

infecção hospitalar prevention and control unidades de tratamento intensivo prevenção e controle hospital infection control committee urinary tract infection infecção comissão de controle de infecção hospitalar infecção da corrente sangüínea bloodstream infection ciencias da saude trato urinário intensive care unit hospital infection

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