Perfil microbiológico e taxa de letalidade das infecções primárias de corrente sanguínea nas crianças menores de um ano em um hospital público de Belém/Pa.

Abstract

Primary Bloodstream Infections (BSI) are among the most prevalent health care-related infections (HAI) and are associated with high morbidity and mortality, especially in young children, preterm, low birth weight newborns and admitted in intensive care units (ICU) . These infections are even more severe when caused by antimicrobial resistant microorganisms common to clinical practice. To determine the type of etiological agents involved in primary BSI acquired hospitals and to know the local profile of antibiotic resistance will improve an appropriate choice of empirical antibiotic therapy and consequent positive impact on clinical outcomes. The objective of this study was to know the microbiological profile and mortality rates of primary BSI in children under one year of age in a public hospital of Belem, a maternal and referral maternity hospital in northern Brazil. A retrospective cohort study was conducted utilizing demographic and microbiologic data and clinical outcome of laboratory-confirmed primary BSIs with a blood culture positive for a known pathogen and its antibiotic susceptibility which was assessed using an automated system Vitek2 (bioMérieux, France), between april 2015 and april 2018. There were 1736 cases of IPCS in children under one year of age with 631 blood culture positive with pathogenic strains. Candida e Klebsiella were the three most prevalent genders; premature newborns, males and low birth weight were the most affected. The ESBL phenotype (extended-spectrum beta-lactamase / extended-spectrum beta-lactamase) occurred in 70,8% Serratia marsecens. Overall crude mortality was elevated, 36,3% (224/617). Use of central venous catheter, mechanical ventilation and admitted in UCI were risk factors to mortality. In multivariate analysis, the pathogen Candida (p = 0.05) was the most significantly associated with deaths. Hospital IPCS are serious adverse events and are associated with a high fatality rate in children under one year of age.