Banca de DEFESA: KALIDYJAMAYRA OLIVEIRA REIS DE FREITAS

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
DISCENTE : KALIDYJAMAYRA OLIVEIRA REIS DE FREITAS
DATA : 30/08/2023
HORA: 17:00
LOCAL: Google Meeting
TÍTULO:

INFECTIONS RELATED TO HEALTH CARE IN THE ICU OF A REFERENCE HOSPITAL IN THE MESOREGION OF THE WEST POTIGUAR

PALAVRAS-CHAVES:

Antibiotics, Health Care-Related Infections, Intensive Care Unit.

PÁGINAS: 72
GRANDE ÁREA: Ciências da Saúde
ÁREA: Saúde Coletiva
RESUMO:

Introduction: Health Care-Related Infections (HAIs) occur more frequently in
Intensive Care Units (ICUs) due to greater patient exposure to invasive procedures
and devices, weakened clinical status, and their handling by the care team. These
practices require greater use of antibiotics, which may lead to bacterial resistance to
these drugs, the consequences of which may be difficulty in treatment, prolonged
hospitalization, higher risk of death and cost of treatment. Objective: To analyze HAI
and its predictor factors in the ICU of a regional reference hospital in the northeastern
semi-arid region in the 2017-2020 quadrennium. Methods: Retrospective,
observational, cross-sectional study with a descriptive approach. The studied
population consisted of 1,682 patients registered by the Hospital Infection Control
Commission admitted to the general ICU of the Regional Hospital Dr. Tarcísio de
Vasconcelos Maia, located in the northeastern semi-arid region, Mossoro-RN, in the
four-year period 2017-2020. Data were collected from HAI notification forms and
added to a specific digital database, with exclusive access to research members,
whose descriptive, bivariate and multiple analysis took place using Microsoft Office
Excel® software and Statistical Package for the Social Sciences. Results: The
analysis reveals a prevalence of males (62%), a median age of 57 years old and the
existence of comorbidities in 57.9% of cases, especially infection prior to the ICU.
The length of stay in the ICU is 11.4 days and the mortality rate is 52%. As for
invasive devices, the use of indwelling urinary catheter (IUC), mechanical ventilation
(MV) and central venous catheter (CVC) is above 78%/1,000 devices-day. There
were 790 HAIs in the ICU. The main HAI incidence densities (ID)/1000 patient-day
were: ID-Urinary Tract Infection 22.3; ID-Pneumonia Associated with Mechanical
Ventilation 27 and ID-Primary Bloodstream Infection 1,8. As for antibiotics, a Length
of therapy (LOT) of 840.5/1000 patient-days was observed, the most prescribed
being: vancomycin; meropenem, ceftriaxone, amikacin and polymyxin, whereas for
Days of therapy/1000 patient-days, the most expressive are meropenem, amikacin,
polymyxin, vancomycin and imipenem. The presence of non-compliance in the
treatment with antibiotics was identified in about 455 patients, which mainly involve
polymyxin, vancomycin, meropenem and ceftriaxone. In the regression model, risk
factors associated with HAI have been identified: length of stay, previous infection in
the ICU, LOT, amount of antibiotics/type used in the ICU and use of carbapenem,
aminoglycoside and nitromidazole. Conclusion: HAI has a high incidence in the ICU,
especially VAP and ACUTI, as well as the use of MV and IUC and a predominance of
the worst outcome in the patient's prognosis, in addition to significant length of stay
and infection prior to the ICU. Seven variables were identified as risk factors
associated with HAI, with 71% of them involving the use of antimicrobials. The study
can collaborate with HAI control and prevention strategies based on knowledge of
the hospital reality, especially based on the management of antimicrobials.

MEMBROS DA BANCA:
Externo à Instituição - MARQUIONY MARQUES DOS SANTOS - UFRN
Interno - 3789 - THALES ALLYRIO ARAÚJO DE MEDEIROS FERNANDES
Externa à Instituição - VÂNIA SOUZA ANDRADE - UFRN