Delineation of infections in a university hospital by bacteria producers of metalobetalactamases: mapping the enemy!

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DOI:

https://doi.org/10.30968/rbfhss.2023.144.0979

Abstract

Objetive: to determine the prevalence of metallo-beta-lactamase (MBL) infections, as well as to outline the epidemiological, clinical, and microbiological profile of these infections and the therapeutic approaches used to combat them in a hospital in Ceará, Brazil, during the period of 2021 and 2022. Methods: A cross-sectional retrospective study was conducted. Systematic data collection was performed from medical records of hospitalized patients, which were subsequently stored in a database. All patients admitted to the ward or ICU who were diagnosed with MBL infection based on microbiological tests conducted after 48 hours of hospitalization were  included in this study. According to these criteria, 79 patients were included in our study. The data were evaluated based on their absolute frequency (n), relative frequency (%), and measures of central tendency. Results: The prevalence of MBL infections among all resistant infections was 47,9%. The average age of the patients was 61.8 years, and the male gender was the most affected (65,8%). The medical clinic had the highest number of cases (20,3%). In 40,5% of the cases, patients were using mechanical ventilation. Blood culture was the most prevalent microbiological test (38%) for diagnosing the infections. Neoplasms were the main cause of patient admissions (34%). The most isolated bacterium was Klebsiella pneumoniae (65,8%), and the prevalent resistance gene was New Delhi Metallo-beta-lactamase (NDM), present in 77,2% of cases. The isolates showed resistance to almost all tested antimicrobials (AMs). The most effective AMs in vitro against these infections were colistin, gentamicin, and amikacin. Polymyxin B was the most commonly used AM, comprising either entirely or partially the treatment for 41,8% of patients. The mortality rate was 43%. Thus, we report for the first time the presence of MBL-producing bacteria in Ceará, with a high prevalence and mortality rate. Conclusion: These results indicate the depletion of therapeutic options against these pathogens and the urgent need to seek new treatments.

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Published

2024-01-08

How to Cite

1.
REIS HC, DE MELO AG, ROSA FL, ARAGÃO VN, OLIVEIRA RM, GIRÃO ES, LIRA ML, AMARAL GP, RODRIGUES JL. Delineation of infections in a university hospital by bacteria producers of metalobetalactamases: mapping the enemy!. Rev Bras Farm Hosp Serv Saude [Internet]. 2024Jan.8 [cited 2024Feb.22];14(4):979. Available from: https://rbfhss.org.br/sbrafh/article/view/979

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