IMPACTO CLÍNICO E PERFIL EPIDEMIOLÓGICO DE INFECÇÕES CAUSADAS POR Enterococcus spp. SENSÍVEIS À VANCOMICINA EM UM HOSPITAL DE LONDRINA/PR

• DOI: https://doi.org/10.22533/at.ed.3542523041

• Palavras-chave: Enterococcus; Infecção hospitalar; Indicadores de morbimortalidade

• Keywords: Enterococcus; hospital infection; morbidity and mortality indicators.

• Abstract: Enterococcus spp. They are gram-positive chain cocci, facultative anaerobes and commensal residents of the intestinal microbiota, however they have the ability to cause infections, especially in immunocompromised patients. The most common Enterococcus species in humans are Enterococcus faecalis (Efc) and Enterococcus faecium (Efm). In the 1980s, the first reports of vancomycin-resistant Enterococcus (VRE) began to appear, and with their increase, vancomycin-sensitive Enterococcus (VSE) lost their relevance. However, there are recent studies that show VSE outcomes that are as impactful as those of VRE, highlighting their importance. The present work seeks to elucidate the clinical impact caused by vancomycin-sensitive Efc and Efm (VSEfc and VSEfm) on patients in a tertiary hospital in southern Brazil. This is a retrospective longitudinal study carried out at the University Hospital in the city of Londrina/PR. The sample covers all patients admitted from August 2022 to August 2023 who presented a positive blood culture or urine culture for VSEfc or VSfm. The study population included 52 patients, with 53.85% of patients being male. The median age was 66.5 years and the most prevalent comorbidities were those related to the cardiovascular (61.54%) and renal (34.62%) systems Regarding length of stay, 25% of patients were hospitalized for one to 14 days while 75% were hospitalized for 15 days or more. The majority of species identified were Efc (51.92%) and urine infections were more related to Efm (76.19% of urine cultures) and blood infections to Efc (70.97% of blood cultures). There was previous use of mechanical ventilation (MV) in 63.46% of patients and hemodialysis in 55.77%. It was found that 81.82% of patients who required MV acquired Enterococcus due to HAIs and 18.18% were community infections. Among patients who remained hospitalized for 15 days or more, 61.54% were infected by Efc. It was found that 61.54% of the sample died. Therapeutic success in the treatment of Enterococcus was considered in 67.31% of patients, who presented a subsequent negative culture for a sample from the same site of infection. Among patients with death without therapeutic success, 75% were male and 62.5% were 70 years old or older. Conclusion: The present study showed that VSEfc was more related to blood infections and longer hospital stays and VSEfm was more related to urinary infections. Deaths without therapeutic success were associated with males and patients aged 70 or over. Regarding death as an outcome in the general population, this was more related to male patients, aged 60 years or older and to previous use of CVC, HD and/or MV