STUDY OF PREVALENCE AND MICROBIAL RESISTANCE RATES AT A PUBLIC HOSPITAL IN RIO DE JANEIRO CITY

Authors

  • Marcus Vinicius da Silva Coimbra
  • Marcus V. da Silva Coimbra Filho
  • Nádia Cristina de Lima

Keywords:

Hospital infection, antimicrobial drugs, resistance

Abstract

Abstract: Antimicrobial resistance among bacterial pathogens is a global problem, but in Brazil data are sparse. This study analyzed the prevalence and resistance rates of the main microorganisms isolated of biologic materials from patients in Intensive Care Unit (ICU) and Non – Intensive Care Unit (N-ICU) at Brazilian Air Force Central Hospital (HCA), during 2005. At microbiologic laboratory, standard methods were used for identification and susceptibility testing. In addition, quality controlled strains were utilized, routinely, to ensure accurate performance of the assays. The analysis of data demonstrated the presence of high resistance rates in most of the bacteria studied. It suggests that resistance, among gram-positive and gram-negative bacilli, is common and significant in hospital studied. The isolates from ICU patients presented resistance patterns higher than those from UI. Resistance rates among Staphylococcus sp. were high but similar those found around the world. The Methicillin-Resistant Staphylococcus aureus (MRSA) prevalence was 26% and 77% when the isolates came from N-ICU and ICU, respectively. In spite of resistance to most relevant antimicrobial has been common among gram-negative bacilli, the majority remained susceptible to imipenem. Particularly alarming are the high resistance rates, presented by K. Pneumoniae from ICU and N-ICU and E.coli from N-ICU, probably because of the extended-spectrum -lactamases (ESBL) enzyme. These results have important implications for physicians at HCA, with regard to empirical antibiotic selection. They also have important implication for authorities involved in hospital management, as well as in the development of policies regarding antibiotic utilization, infection control and public healthcare.

References

Jones RN. Resistance patterns among nosocomial pathogens: trends over the past few years. Chest 2001; 119(2Suppl):397S–404S.

Brasil. Ministério da Saúde. Secretaria Nacional de Assistência à Saúde. Manual de Procedimentos Básicos em Microbiologia Clínica para Controle de Infecção Hospitalar. Brasília-DF, 1991.

Kim SH, Park WB, Lee KD, Kang CI, Bang JW, Kim HB, et al. Outcome of inappropriate initial antimicrobial treatment in patients with methicillin-

resistant Staphylococcus aureus bacteraemia. JAC, 54(2):489-97.

Leibovici1 L, Soares-Weiser1 K, Paul M, Goldberg E, Herxheimer A, Garner P. Considering resistance in systematic reviews of antibiotic treatment. JAC 2003; 52:564–571.

Cristino JM. O laboratório de microbiologia e a infecção hospitalar. RFML 2000; 5( 1): 13–16.

Ferraro MJ, Jorgensen H. Instrument–Based Antibacterial Susceptibility Testing. In: Murray PR et al. Manual of Clinical Microbiology. 6. ed. Washington, DC: ASM Press, 1995. p. 1379-1384.

McGowan Junior JE, Metchock B. Infection Control Epidemiology and Clinical Microbiology. In: Murray PR et al. Manual of Clinical Microbiology. 6. ed. Washington, DC: ASM Press, 1995. p. 182-189.

Pfaller MA, Cormican MG. Microbiology: The Role of the Clinical Laboratory. In: Wenzel RP. Prevention and Control of Nosocomial Infections. 3. ed. Baltimore: Williams and Wilkins, 1997b. p. 95–118

Brasil. Ministério da Saúde. Agência Nacional de Vigilância Sanitária. Portaria no 2616, de 12 de maio de 1998. Programa de Controle de Infecção Hospitalar. Brasília, DF, 1998.

Cohen ML. Epidemiology of drug resistance: implications for a postantimicrobial era. Science1992; 257(5073):1050–1055.

Wenzel RP. Prevention and Control of Nosocomial Infections. 3. ed. Baltimore: Williams and Wilkins, 1997.

Haley RW, Schaberg DR, Von Allmen SD, McGowan JE Jr. Estimating the extra charges and prolongation of hospitalization due to nosocomial infections: a comparison of methods. J Infect Dis 1990; 141(2):248-257.

Ibrahim EH, Sherman G, Ward S, Fraser VJ, Kollef MH. The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest 2000; 118(1):146–155.

Kollef MH, Sherman G, Ward S, Fraser VJ. Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically III patients. Chest 1999; 115(2): 462–474.15. Baslow G, Nathwani D. Is antibiotic resistance a problem? A pratical guide for hospital clinicians. Postgrad Med J 2005; 81(961): 680–692.

Ena J. Optimal use of antibiotics. In: Wenzel RP. Prevention and control of nosocomial infections. 3. ed. Baltimore: Williams and Wilkins, 1997. p. 323–338.

Hogenzeil HV, Sallami AO, Walker GJA, Fernando G. Impact of an essential drugs programme on availability and rational use of drugs. Lancet 1989; 1:141–142.

McDougall C, Polk RE. Antimicrobial stewardship programs in health care systems. Clin Microbial Rev 2005; 18(4):638–656.

Murray PR et al. Manual of clinical microbiology. 6. ed. Washington, DC: ASM Press, 1995.

Dias Neto JA, Silva LDM, Martins ACP, Tiraboschi RB, Domingos ALA, Suaid HJ, et al. Prevalence and bacterial susceptibility of hospital acquired urinary urinary tract infection. Acta Cir Bras 2003; 18(5):36–38.

Herwalt LA, Wenzel P. Dynamics of Hospital-Acquired Infection. In: Murray PR et al. Manual of Clinical Microbiology. 6. ed. Washington, DC: ASM Press, 1995. p. 169-181

Manthous, CA, Amoteng-Adjepong Y. Empiric antibiotic use and resistant microbes. Chest 2000; 118(1):9–11.

Brooks GF et al. Medical microbiology. 9. ed. London: Prentice Hall International. 1991.

National Committee for Clinical Laboratory Standards (NCCLS). Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. Villanova, 2005.

Stager CE, Davis JR. Automated systems for identification of microorganisms. Clin Microbiol Rev 1992; 5(3):302–327.

Published

2012-02-05

How to Cite

Coimbra, M. V. da S., Coimbra Filho, M. V. da S., & Lima, N. C. de. (2012). STUDY OF PREVALENCE AND MICROBIAL RESISTANCE RATES AT A PUBLIC HOSPITAL IN RIO DE JANEIRO CITY. Revista De Divulgação Científica Sena Aires, 1(1), 58–66. Retrieved from https://rdcsa.emnuvens.com.br/revista/article/view/905

Issue

Section

Original Paper