Studiu epidemiologic privind infecțiile nosocomiale cu Acinetobacter

Abstract

Introduction. Acinetobacter baumannii is a pathogen and a major cause of nosocomial infections in the current healthcare system worldwide due to its high resistance to antibiotics, including those considered as a last resort, thus posing threat to severe clinical forms, as well as exhibiting significant economic and clinical impact. Material and methods. A descriptive longitudinal and cross-sectional epidemiological study was carried out based on the model of multidisciplinary care hospitals.Results.The generalized clinical forms of Acinetobacter nosocomial infections predominate in 56.30%, including: pulmonary sepsis – 25.59%, abdominal sepsis – 11.81%, septicemia –9.45%, wound sepsis – 6.30%, biliary sepsis – 1.97%, and urosepsis –1.18% of cases. Local infections were found in 16.93% of wound infections and in 14.57% of pneumonia cases. A. baumanii was present in the etiological structure of 98.18% of cases, exhibiting an increased resistance to antibiotics, particularly to monobactams –100.0%, macrolides – 98.82%, penicillins – 98.08%, cephalosporins – 97.65%, penicillins with beta-lactamase inhibitors – 93.20%, fluoroquinolones – 87.16%, and amphenicols – 84.17% of cases. A. baumanii strains isolated from patients with nosocomial infections were found to be multidrug-resistant to antibiotics in 93.08% of cases. Conclusions. Acinetobacter baumannii nosocomial infections represent a major public health issue that requires the implementation of strict surveillance and control strategies, including the rational use of antibiotics.

Introducere. Acinetobacter baumanii prezintă un agent patogen ce cauzează infecții nosocomiale, devenind, actualmente o amenințare globală de sănătate publică din cauza nivelurilor ridicate de rezistenţă la antibiotice, inclusiv la cele considerate de ultimă instanță, formelor clinice severe, impactului economic şi clinic semnificativ.Material și metode. A fost realizat un studiu epidemiologic descriptiv longitudinal şi transversal pe modelul staționarelor multiprofil. Rezultate. În structura infecțiilor nosocomiale cu Acinetobacter predomină formele clinice generalizate – 56,30%, inclusiv: sepsis pulmonar – 25,59%, sepsis abdominal – 11,81%, septicemii – 9,45%, sepsis tegumentar –6,30%, sepsis colangiogen – 1,97%, sep-sis uronefrogen –1,18%. Din infecțiile locale predomină infecțiile de plagă –16,93% și pneumoniile – 14,57%. În structura etiologică predomină A. baumanii – 98,18%, rezistența la antibiotice fiind sporită, inclusiv la monobactame – 100,0%, macrolide – 98,82%, peniciline – 98,08%, cefalosporine –97,65%, peniciline cu inhibitori de betalac-tamaze – 93,20%, fluorochinolone – 87,16%, amfenicoli - 84,17%. Tulpinile de A. baumanii izolate de la pacienții cu infecții nosocomiale în 93,08% s-au dovedit a fi polirezistente la antibiotice. Concluzii. Infecțiile nosocomiale cu Acinetobacter prezintă astăzi o problemă majoră de sănătate publică și necesită implementarea strategiilor stricte de supraveghere și control, inclusiv a utilizării raționale a antibioticelor.