High lethality rate of carbapenem-resistant <i>Acinetobacter baumannii</i> in Intensive Care Units of a Brazilian hospital: An epidemiologic surveillance study

Kurihara, Mariana Neri Lucas; Sales, Romário Oliveira de; Silva, Késia Esther da; Silva, Gerlaine Damasceno; Mansano, Maria Carolina Tazinazzo; Mahmoud, Fuad Fayez; Simionatto, Simone

doi:10.1590/0037-8682-0529-2021

person Mariana Neri Lucas Kurihara

school Universidade Federal da Grande Dourados, Laboratório de Pesquisa em Ciências da Saúde, Dourados, MS, Brasil.

0000-0003-4394-3749

person Romário Oliveira de Sales

school Universidade Federal da Grande Dourados, Laboratório de Pesquisa em Ciências da Saúde, Dourados, MS, Brasil.

0000-0002-4668-6752

person Késia Esther da Silva

school Universidade Federal da Grande Dourados, Laboratório de Pesquisa em Ciências da Saúde, Dourados, MS, Brasil.schoolStanford University, Division of Infectious Diseases and Geographic Medicine, Stanford, CA, USA.

0000-0001-8593-1119

person Gerlaine Damasceno Silva

school Universidade Federal da Grande Dourados, Laboratório de Pesquisa em Ciências da Saúde, Dourados, MS, Brasil.

0000-0002-3763-8337

person Maria Carolina Tazinazzo Mansano

school Universidade Federal da Grande Dourados, Laboratório de Pesquisa em Ciências da Saúde, Dourados, MS, Brasil.

0000-0003-3372-3275

person Fuad Fayez Mahmoud

school Universidade Federal da Grande Dourados, Hospital Universitário de Dourados, Dourados, MS, Brasil.

0000-0002-0025-9130

person Simone Simionatto

school Universidade Federal da Grande Dourados, Laboratório de Pesquisa em Ciências da Saúde, Dourados, MS, Brasil.

0000-0003-2367-0915

Corresponding author: Dr. Simone Simionatto
e-mail:simonesimionatto@ufgd.edu.br

Authors’ contribution: MNLK, SS: Study conception and design; MNLK, GDS, MCTM, FFM: Acquisition of data; MNLK, ROS, KES, FFM, SS: Analysis and interpretation of data; MNLK, SS: Drafting of manuscript; SS: Critical revision.

Conflict of Interest: The authors declare that there is no conflict of interest.

Variables	Validated cases	Nº
		2015	2016	2017
Records analyzed	89 (100%)	37 (41.6%)	22 (24.7%)	30 (33,7%)
Resistance profile
Susceptible	7 (7.9%)	5 (13.5%)	2 (9.1%)	-
Resistant	82 (92.1%)	32 (86.5%)	20 (90.9%)	30 (100%)
Sex
Man	48 (58.5%)	15 (46.9%)	14 (70%)	19 (63,3%)
Woman	34 (41.5%)	17 (53.1%)	6 (30%)	11 (36,7%)
Age
More than 60 years	43 (52.4%)	18 (56.2%)	9 (45%)	16 (53,3%)
Among 18 to 59 years	34 (41.5%)	14 (43.8%)	8 (40%)	12 (40%)
Among 0 to 18 years	5 (6,1%)	-	3 (15%)	2 (6,7%)
Ward
Adult Intensive Care Unit A	35 (42.7%)	14 (43.7%)	10 (50%)	11 (36,6%)
Adult Intensive Care Unit B	42 (51.2%)	18 (56.3%)	7 (35%)	17 (56,7%)
Neonatal Intensive Care Unit	2 (2.4%)	-	2 (10%)	-
Pediatric Intensive Care Unit	3 (3.7%)	-	1 (5%)	2 (6,7%)
Isolated material
Tracheal aspirate	39 (47.6%)	14 (43.8%)	13 (65%)	12 (40%)
Catheter tip	7 (8.6%)	1 (3.1%)	3 (15%)	3 (10%)
Swab	26 (31.7%)	15 (46.9%)	-	11(36.7%)
Blood culture	6 (7.3%)	1 (3.1%)	2 (10%)	3 (10%)
Uroculture	2 (2.4%)	-	1 (5%)	1 (3.3%)
Eschar	1 (1.2%)	1 (3.1%)	-	-
Vaginal secretion	1 (1.2%)	-	1 (5%)	-
Comorbity
Pneumonia	52 (63.4%)	21 (65.7%)	15 (75%)	16 (53.3%)
Systemic arterial hypertension	36 (43.9%)	17 (53.1%)	7 (35%)	12 (40%)
Ischemic vascular stroke	12 (14.6%)	7 (21.9%)	3 (15%)	2 (6.7%)
HIV-AIDS	7 (8.5%)	2 (6.2%)	2 (10%)	3 (10%)
Diabetes mellitus	35 (42.7%)	14 (43.8%)	7 (35%)	14 (46.7%)
Sepsis	23 (28%)	7 (21.9%)	6 (30%)	10 (33.3%)
Pulmonary sepsis	20 (24.4%)	10 (31.3%)	4 (20%)	6 (20%)
H1N1 influenza	4 (4.9%)	1 (3.1%)	3 (15%)	-
Tuberculosis	3 (3.7%)	-	-	3 (10%)
Acute renal failure	28 (34.1%)	13 (40.6%)	5 (25%)	10 (33.3%)
Congestive heart failure	7 (8.5%)	5 (15.6%)	1 (5%)	1 (3.3%)
COPD	10 (12.2%)	5 (15.6%)	3 (15%)	2 (6.7%)
Acute respiratory insufficiency	17 (20.7%)	6 (18.8%)	3 (15%)	8 (26.7%)
Invasive Procedures
Mechanical ventilation	71 (86.6%)	26 (81.2%)	20 (100%)	25 (83.3%)
NP/VDP	72 (87.8%)	27 (84.4%)	18 (90%)	27 (90%)
Tracheostomy	30 (36.6%)	10 (31.3%)	7 (35%)	13 (43.3%)
Central venous access	46 (56.1%)	18 (56.3%)	12 (60%)	16 (53.3%)
Surgery	17 (20.7%)	3 (9.4%)	10 (50%)	4 (13.3%)
Hemodialysis	21 (25.6%)	5 (15.6%)	5 (25%)	11 (36.7%)

[TFN1] ICU A: intensive care unit A; ICU B: intensive care unit B; HIV-AIDS: acquired immunodeficiency syndrome; NP/VDP: nasoenteric probe/vesical delay probe; COPD: chronic obstructive pulmonary disease.

High lethality rate of carbapenem-resistant Acinetobacter baumannii in Intensive Care Units of a Brazilian hospital: An epidemiologic surveillance study