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Publication
Impacto da COVID-19 no perfil de resistência aos antibióticos de isolados microbiológicos de um Serviço de Medicina Intensiva
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| 1.14 MB | Adobe PDF |
Advisor(s)
Abstract(s)
As infeções por microrganismos multirresistentes e a crescente resistência aos antibióticos são uma realidade preocupante dos hospitais portugueses. Desde o início da pandemia COVID-19, tem vindo a questionar o seu impacto na emergência e disseminação de microrganismos com perfil de multirresistência. Enquanto a consciencialização para as práticas de prevenção e controlo de infeção contribuem para a redução da incidência, o uso indiscriminado de terapêutica antibiótica empírica bem como a pressão nos serviços de saúde podem ter o efeito inverso. Foi analisado, de forma retrospetiva e transversal, um total de 1.179 isolados microbiológicos provenientes de 1698 doentes admitidos na Unidade de Cuidados Intensivos do Hospital Prof. Doutor Fernando da Fonseca, entre janeiro de 2019 e fevereiro de 2021, de modo a calcular incidência indexada a 10.000 doentes dos microrganismos isolados com perfil de multirresistência, separando os resultados consoante o seu isolamento no período pré-COVID (de janeiro de 2019 a janeiro de 2020) ou período COVID (janeiro 2020 a fevereiro de 2021). Foram também calculados o consumo de antibióticos e a demora média de internamento para cada um dos períodos referidos, pelo seu reconhecimento como agentes da emergência de multirresistências. Verificou-se uma diminuição de cerca de 55% da incidência dos isolados de microrganismos com perfil de multirresistência, entre o período pré-pandémico e o período pandémico, apesar de um aumento de 30,2% no consumo antibiótico e de 17,9% na demora média de internamento correspondentes. A implementação de medidas reforçadas de prevenção e controlo de infeção e a implementação de planos de contingência para o controlo da COVID-19 poderão terseguindo a tendência já apresentada na literatura atual. No entanto, não podemos negligenciar as possíveis consequências que a longo prazo possam advir do aumento do consumo antibiótico no que concerne à resistência aos antibióticos. condicionado a diminuição de isolados microbiológicos com perfil de multirresistência,
Infections caused by multi-drug resistant organisms and the increasing antibiotic resistance are a concerning realty in the hospitals of Portugal. The impact of COVID-19 on the emergence and dissemination of multi-drug resistant organisms has been questioned since the beginning of the pandemic. While the awareness brought to infection control and prevention strategies might contribute to lowering the incidence of the infections associated with these organisms, the indiscriminate use of empirical antibiotic therapy as well as the pressure the health systems have been under might have an opposite effect, increasing these organisms. We conducted a retrospective and observational analysis of a total of 1.179 microbiological isolates regarding 1.698 patients admitted to Hospital Prof. Doutor Fernando da Fonseca’s Intensive Care Unit, between January of 2019 and February of 2021, in order to calculate the incidence per 10.000 patients/year of the isolates with a multi-drug resistant profile, later splitting the results based on the period they were identified (Pre-COVID, between January 2019 and January 2020, and COVID, between January 2020 and February 2021). We additionally estimated the antibiotic consumption as well as the median length of stay since their recognition as contributors to the antibiotic resistance problematic. We verified a decrease of 55% regarding the incidence of the multi-drug resistant organisms’ isolates, from the Pre-COVID to the COVID period despite the increase of 30,2% in antibiotic consumption and 17,9% increase in duration of length of stay during the COVID period.
Infections caused by multi-drug resistant organisms and the increasing antibiotic resistance are a concerning realty in the hospitals of Portugal. The impact of COVID-19 on the emergence and dissemination of multi-drug resistant organisms has been questioned since the beginning of the pandemic. While the awareness brought to infection control and prevention strategies might contribute to lowering the incidence of the infections associated with these organisms, the indiscriminate use of empirical antibiotic therapy as well as the pressure the health systems have been under might have an opposite effect, increasing these organisms. We conducted a retrospective and observational analysis of a total of 1.179 microbiological isolates regarding 1.698 patients admitted to Hospital Prof. Doutor Fernando da Fonseca’s Intensive Care Unit, between January of 2019 and February of 2021, in order to calculate the incidence per 10.000 patients/year of the isolates with a multi-drug resistant profile, later splitting the results based on the period they were identified (Pre-COVID, between January 2019 and January 2020, and COVID, between January 2020 and February 2021). We additionally estimated the antibiotic consumption as well as the median length of stay since their recognition as contributors to the antibiotic resistance problematic. We verified a decrease of 55% regarding the incidence of the multi-drug resistant organisms’ isolates, from the Pre-COVID to the COVID period despite the increase of 30,2% in antibiotic consumption and 17,9% increase in duration of length of stay during the COVID period.
Description
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021
Keywords
SARS-CoV-2 Bactérias multirresistentes Antibióticos