Aspectos epidemiológicos da sepse em unidades de terapia intensiva

2009 ◽  
Vol 3 (4) ◽  
pp. 1184
Author(s):  
Glaucea Maciel de Farias ◽  
Mirna Cristina da Silva Freitas ◽  
Karolina De Moura Manso da Rocha ◽  
Isabel Karolyne Fernandes Costa ◽  
Luíz Alves Morais Filho

Objective: to characterize patients that suffered sepsis in Intensive Care Units. Methods: bibliographic research, performed in the Domínio Público and Biblioteca Virtual em Saúde (BVS/BIREME), websites, specifically Base de Dados de Enfermagem (BDENF), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Literatura Internacional em Ciências da Saúde (MEDLINE), Scientific Electronic Library Online (SciELO), with studies ranging from 2001 to April 2009. We used the search words: “Sepse” and “Unidades de Terapia Intensiva”. Results: the male gender was most affected (56%), with a related age group of 57 to 71. The main focal point for the beginning of sepsis was the pulmonary system. The most often identified pathogens were gram-negative germs (65%). The washing of hands was approached on 90% of the related studies as the main procedure for infection control. Conclusions: male individuals were most often afflicted by sepsis and averaged 65 years of age. The pulmonary system was the area most often associated with the beginning of sepsis. Gram-negative bacteria were the pathogens most often found in studies and the washing of hands was the most emphasized procedure for the prevention of infections in this environment. Descriptors: sepsis; intensive care units; cross infection; nursing.

2019 ◽  
Vol 40 (04) ◽  
pp. 558-568 ◽  
Author(s):  
Solen Kernéis ◽  
Jean-Christophe Lucet

AbstractThe prevalence of multidrug-resistant organisms (MDROs) in intensive care units (ICUs) is increasing worldwide, with very large variations across countries, microorganisms, and settings. Emerging MDR gram-negative bacteria and fungi raise particular concerns that require improved prevention and control strategies. Vertical approaches are mainly based on screening and contact precautions and/or decolonization of MDRO carriers. On the other hand, horizontal strategies are not pathogen-specific and include standard precautions (i.e., hand hygiene), universal decolonization, antimicrobial stewardship, and environmental cleaning. The impacts of the different strategies vary between MDROs and compliance with control measures, and are intermixed in most infection control programs. Based on historical data, hand hygiene remains the cornerstone to prevent transmission of MDROs in ICUs. In the context of high hand hygiene compliance, screening and contact precautions for carriers seem to have a limited additional effect, particularly for MDR gram-negative bacteria. Studies on skin decolonization with chlorhexidine bathing show conflicting results, impairing its widespread adoption. Selective oral and digestive decontaminations have shown positive impact on clinical outcomes in ICUs with low levels of antibiotic resistance, but raised ecological concerns in high-prevalence settings. Antibiotic stewardship programs have been associated with reductions in antimicrobial use, duration of stay, and costs with no negative impact on mortality and should be widely promoted in ICUs. Whatever the strategy, compliance with the recommended measures is of crucial importance and implementation should rely on behavioral approach and change in the institutional and safety culture.


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