Bacteremia por Staphylococcus epidermidis em neonatos: incidência e fatores de risco
Palabras clave:
Bacteremia, Fatores de risco, Recém-nascido, Staphylococcus epidermidisResumen
Objetivo
Avaliar a incidência de bacteremia por Staphylococcus epidermidis e sua associação com o baixo peso, com o uso de cateter vascular central e com o escore de gravidade (Score for Neonatal Acute Physiology) em uma Unidade de Terapia Intensiva Neonatal de um hospital universitário brasileiro.
Métodos
Foi realizado um estudo caso-controle na Unidade de Terapia Intensiva Neonatal, utilizando-se a vigilância National Nosocomial lnfection System, no período entre
janeiro de 2004 e dezembro de 2005. Uma ficha individual foi preenchida, contendo dados demográficos, clínicos e epidemiológicos. As culturas de sangue positivas para 5taphy/ococcus coagulase-negativa foram identificadas nas respectivas espécies.
Resultados
A taxa de incidência de infecção hospitalar, definida por critérios microbiológicos, foi de 19,7 %, sendo estas infecções representadas, em sua maioria, por episódios de sepse (88,8%) Os 5taphy/ococcus coagulase-negativa responderam por 68,8% dessas bacteremias, representados por 5. epidermidis (97,7%) e 5. haemolyticus (2,3%). O baixo peso (,;;1.500g), o uso de cateter vascular central inserido por flebotomia e o valor de escore de gravidade maior ou igual a 20 foram fatores de risco estatisticamente significantes (p,s"0,05) para infecção por 5. epidermidis. As taxas de infecção por 5. epidermidis relacionadas ao uso de cateter vascular central e a densidade de incidência/1 000 dias de uso deste foram de 18,2 % e 37,2%0 para flebotomia; 6,6% e 19,8%0 para intracath; 4,3% e 10,2%0 para cateter central de inserção periférica; 2,5% e 5,5%0 para umbilical, respectivamente.
Conclusão
Os 5taphylococcus coagulase-negativa são responsáveis pela maioria dos episódios de sepse na Unidade de Terapia Intensiva Neonatal, representados quase que exclusivamente por 5. epidermidis. Os fatores de risco: peso menor ou igual a 1 500g, uso de cateter vascular central inserido por flebotomia e valores de escore de gravidade maiores ou iguais a 20 foram associados a estas infecções.
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