Estudo das infecções hospitalares em pacientes com HIV/AIDS hospitalizados e da colonização nasal pos Staphylococcus aureus em pacientes com HIV/AID não hospitalizados

AUTOR(ES)
DATA DE PUBLICAÇÃO

2004

RESUMO

Patients with HIV/AIDS have potentially higher risk for Nosocomial Infection (NI) acquisition comparing other hospitalized groups of patients. In reviewing literature, the most common infection in these patients is the Blood Stream Infection (BSI) and the Staphylococcus aureus is the principal etiologic agent. The present study was developed in two phases. Phase I was developed at the Infectious Diseases Ward (IDW) in the Hospital das Clínicas (HC) from Universidade Estadual de Campinas (UNICAMP) evaluating NI developed among patients who were HIV-positive and comparing to NI developed among patients who were HIV-negative. Phase II objective was to study the S. aureus nasal colonization from HIV-positive outpatients without history of hospitalization within two years before the beginning of the follow-up of this study and was developed at the Unidade de Pesquisa Clínica (UPC) of de Infectious Diseases Department from UNICAMP. Three samples of nares swabs were collected in different days. The DNA profiles of the samples of S. aureus obtained from patients were analyzed by using Pulsed-Field Gel Electrophoresis (PFGE). Potential risk factors associated to the nasal colonization for S. aureus were accessed. Phase I results showed that HIV-positive patients had higher rates of NI than HIV-negative patients. The HIV-patients were more likely to have a central venous catheter or urinary catheter than HIV-negative patients cared for in the same ward. The most frequent NI site was the BSI and the S. aureus was the principal identified etiologic agent. HIV-positive patients were more likely to have S. aureus infection compared to the HIV-negative patients. Results from Phase II detected the presence of S. aureus nasal colonization in 70 of 111 enrolled HIV-patients (63,1%). Nasal colonization for S. aureus were classified as: a) absent: patients having three negative results, in 36% of the cases; b) transient: patients having one positive results, in 25% of the cases; and c) persistent: patients having two or three positive results, in 39% of the cases. By using PFGE, the last category were subdivided into: c1) simple persistent, patients having two or three positive samples with the same DNA profile, in 24% of cases; c2) multiple persistent, patients having positive samples with different profiles, in 7% of cases, and, c3) combined persistent, patients having two positive samples with the same profile and one positive sample with different profile, in 8% of cases. Clinical and laboratorial classification of AIDS, using Centers for Disease Control and Prevention (CDC) criteria, was identified as the risk factor for S. aureus nasal colonization. The antibiotics use at the moment of collection of nasal swab or 6 months before were associated with negative results for S. aureus. No specific risk factors were associated with different types of colonization

ASSUNTO(S)

antibioticos - resistencia em microrganismos dna - analise septicemia epidemiologa molecular infecção - pacientes - hospitais infecções estafilicocicas

ACESSO AO ARTIGO

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