Indicadores epidemiológicos das infecções relacionadas à assistência à saúde dos hospitais de Belém-Pa sob a ótica da vigilância sanitária

Abstract

The term Hospital Infection (HI) has been substituted by Healthcare-Associated Infections (HAIs) because they embrace the infections the patient can acquire in other healthcare services, besides hospitals. The HAIs show larger incidence in the Intensive Therapy Units (ITUs). The failures in the tools sterilization processes, the lack of antimicrobian patterning and the failure in the hands hygienic technics are some factors that contribute to acquire infections, resulting in the mortality increase, in the internment period increase and in the healthcare expenses elevation. Concerning to the legislation, Federal Law 9.431/1997 made obligatory for each hospital creating HAIs Control Commissions and keeping HAIs Prevention and Control Programs, as measures to prevent and control this phenomenon. It is due to Sanitary Vigilance inspecting the Hospitals’ HAIs Control Commissions, supported by sanitary inspection and documental analysis. This procedure allows picking up epidemiologic information about HAIs in each hospital, enabling the HAIs tax calibration, as well as information about microorganisms which round the hospitals the most. The objective proposed has been describing Belém’s Hospitals’ HAIs epidemiological profile through the Sanitary Vigilance’s view, in the period between 2011 and 2014. It’s about historic series ecologic study, with secondary data, collected in the Belém’s Sanitary Vigilance Department Data Base, referring to the HAIs informed by 32 hospitals, between 2011 and 2014. The study results show that 68,8% of the hospitals are particular and 31,2% are public; that 71,9% have Intensive Therapy Unit rooms, 60,87% of them in the particular net. Concerning to the HAIs Control Commissions’ behave, 56,2% of the hospitals count on active Commissions, while 43,8% don’t count on active ones. About Infection Indicators, HAIs’ tax keeps around 3,3%. The infected patients’ tax reached 2,7% in 2012. HAIs’ obits reached it’s higher increase in 2011, 14,3%. The respiratory tract infection has been the highest incidence topography, reaching the tax of 24% in 2012. Followed by the urinary tract infections (14,2% to 17,6%), blood flows infections (13,5% to 17,9%), skin (7,5% to 5,3%), intestine infections (5,7% to 6,1%), surgery site infections (0,9 to 1,0%), clean surgery infections (0,2% to 0,8%), neonatal blood infections (1,6% to 2,1%) and other topographies’ infections (3,3%). Pathogens that involved the most in infectious process were Pseudomonas aeruginosas (96%), Klebsiella pneumoniae (92%), Escherichia coli, Staphylococcus aureus and Staphylococcus epidermidis (80%) and Acinetobacter baumanni (72%). We conclude that a considerable number of hospitals in Belém don't monitor adequately the HAIS' occurrence, because the lack of active controls and of HAIS' Control Program implementation in a hospital can reflect unconsistent epidemiological data. Hospitals without active commissions can’t show indicators that reflect its epidemiological reality properly. So, it’s quite necessary that Sanitary Vigilance acts in a more incisive way in the hospitals, towards improving the process of controlling infections and ameliorating epidemiological indicators. This action will contribute to make sanitary department and hospitals comply their institutional missions, that are “eliminate, diminish and prevent risks and damages related to the patient’s health”.