DENSIDADE DE INCIDENCIA DE PATÓGENOS GRAM POSITIVOS, PERTENCENTES AO GRUPO SKAPE, EM UNIDADES DE TERAPIA INTENSIVA DE UM HOSPITAL UNIVERSITÁRIO DO SUL DO BRASIL.

• DOI: https://doi.org/10.22533/at.ed.3232524041

• Palavras-chave: Patógenos multirresistentes; Antimicrobianos; ESKAPE; Enterococcus spp.; Staphylococcus aureus.

• Keywords: Multidrug-resistant pathogens; Antimicrobials; ESKAPE; Enterococcus spp.; Staphylococcus aureus.

• Abstract: The main pathogens associated with healthcare-associated infections, which have a large arsenal of resistance and virulence, are the so-called "ESKAPE" pathogens, which include Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp. In addition, there is a trend of increasing antibiotic resistance rate, especially in isolates of Methicillin-Resistant S. aureus (MRSA), Vancomycin-Resistant Enterococcus (VRE) and carbapenem-resistant Gram-negative bacteria. Secondary infections of bacterial origin related to COVID-19 play a crucial role in the morbidity and mortality of patients. Faced with a chaotic and uncertain situation, there has been an increase in the occurrence of indiscriminate use of antimicrobials, generating a negative impact on the spread of antimicrobial resistance. The present study aimed to determine the incidence density of colonization by Enterococcus spp. and S. aureus in patients admitted to Intensive Care Units, in the pre-pandemic period (July 2018 to March 2020) and during the pandemic (April 2020 to July 2021). The study included culture results from several clinical materials to investigate colonization by microorganisms from the ESKAPE group. Culture results were obtained from the AGTA Health Information System database, LABHOS® module, of the Clinical Analysis Laboratory (LAC/HU). A total of 11,041 patients were admitted to Intensive Care Units during the period, corresponding to 47,506 patient-days, 12,675 from the pre-pandemic period and 34,831 from the pandemic period. A total of 9,026 pathogens from the ESKAPE group were identified during the period, of which 186 (2%) were classified as VRE and 458 (5%) as MRSA. It was found that, for VRE, the mean incidence density varied from 2.3/1,000 patient-days in the pre-pandemic period to 3.9/1,000 patient-days in the pandemic period. On the other hand, for MRSA, the mean incidence density, from the pre-pandemic period, of 4.8/1,000 patient-days varied negatively to 3.5/1,000 patient-days during the pandemic. The results obtained demonstrate that the COVID-19 pandemic had an impact on the frequency of multidrug-resistant gram-positive cocci in the ICUs of HU-UEL, since there was an increase in the incidence density of VRE infections and a reduction in the numbers of MRSA.