MULTIPLE-DRUG RESISTANCE IN BURNED PATIENTS: A 5-YEAR STUDY AT A TEACHING HOSPITAL IN LONDRINA (2013-2017)

Patients who suffer severe burns are at higher risk for local and systemic infections. In recent years, emerging resistant pathogens have forced burn care providers worldwide to search for alternative forms of treatment. A group of pathogens knew as “ESKAPE”, bacteria encompassing both Gram-positive and Gram-negative species, made up of Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species are common causes of life-threatening nosocomial infections amongst critically ill and immunocompromised individuals and are characterized by potential drug resistance mechanisms. The incidence and frequency of these microorganisms are known to vary across different nosocomial units and different hospitals. With this in mind, we sought to evaluate the incidence of the ESKAPE pathogens in the Burned Intensive Care Unit (ICU) of a teaching hospital in Londrina. The retrospective study covered burned patients hospitalized between January 2010 and December 2017. The data was obtained from the AGTA Healthcare Information System, LABHOS® module, from the Laboratory of Clinical Analyzes (LAC-HU). The study was conducted in accordance with the methodology recommended by the European Center for Disease Prevention and Control (ECDC). The incidence density by 1.000 patients-day of infection was investigate. Only one case by patient was included. Carbapenem-Resistant Klebsiella pneumoniae (AbCR) Acinetobacter baumannii Carbapenem-Resistant, (PaCR) Pseudomonas aeruginosa Carbepenem-Resistant, (EcCR) Enterobacter-Resistant Enterovirus (MRSA) Entercoccus faecium resistant to vancomycin, (MRSA) Staphylococcus aureus (KpCR) Carbapenem-resistant cloace. The results found was first in descending order of incidence Acinetobacter baumannii (34.3%), with an increase with the years, second Pseudomonas aeruginosa (25.4%) with a slight decline between 2016 and 2017, third Klebsiella pnseumoniae (18.9%) in fourth Staphylococcus aureus (14.7%), both increasing with the years, in the fifth Enterococcus faecium (2%) showed a slight increase in 2016 but returning to lower levels in 2017, finally the Enterobacter cloace (4.7%) at very low level in both profiles. The only difference between the profiles was that in the resistance profile of ESKAPE to Pseudomonas a. is at a lower level than Staphylococcus a. in 2017 being and of the profile of ESKAPE both are at the same level in 2017. Due to the increase of resistant bacteria, it creates an urgent need to implement strategies to reduce the spread of these infectious cases, such as hygiene programs and awareness of health professionals.