Ocorrência de bactérias do grupo ESKAPE, perfil de susceptibilidade aos antimicrobianos e relação com infecções relacionadas à assistência em saúde (IRAS) em um hospital de ensino de Pelotas, RS, Brasil

Abstract

Due to its high capability to resist and and there is a group of pathogens, denominated ESKAPE, that cause serious infections, usually related to healthcare (HAI), with high mortality and few therapeutic options available. The bacteria that belong to this group are: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.. In order to determine the positive culture prevalence to ESKAPE bacteria group during the years 2017 to 2019, and relate them with the healthcare associated infection (HAI) occurrence, a retrospective cross-sectional epidemiological study was carried out in the databases of a teaching hospital in Pelotas, RS, Brazil. Prevalence data for positive cultures for bacteria in the ESKAPE group were collected, and from positive cultures was obtained data as sample locations and antimicrobial resistance profile. Information such as the main microorganisms isolated in HAIs were collected through monthly reports issued by the Hospital Infection Control Commission (CCIH). It was reported 1105 positive cultures identified as ESKAPE bacteria between the years 2017-2019. In cultures positives, K. pneumoniae was the most prevalent bacterium (40,27%, n=445), being widely found in urine cultures, and the one that causes the most HAIs. Other bacteria in the group ESKAPE were tightly related to HAIs. The carbapenem resistance of Gram negative bacteria in the ESKAPE group remained stable in A. baumannii and had an increasing trend over the years in K. pneumoniae, Enterobacter spp. and P. aeruginosa. The E. faecium bacterium showed high resistance to vancomycin. And, in S. aureus, a significant drop in resistance to methicillin was observed in 2019. As in other locations, the bacteria of the ESKAPE group are present for the region of Pelotas, RS, Brazil, having relation with HAIs and, in general terms, the high rate of resistance to antimicrobials presented by these pathogens in the study hospital follows the growing world trend, with fewer therapeutic options available.