Clinical and epidemiological characterization of multiresistant bacteria isolated from the blood of trauma victims

Abstract

Currently, most studies on colonization and infection by multidrug-resistant agents (MDR) in trauma patients focus on cohorts of patients admitted to hospitals specializing in the care of war veterans or cohorts of patients who are victims of burns in domestic or civil war. In these studies, colonization and infection rates by MDR agents, mainly carbapenem-resistant enter bacteria, were published, identifying their mechanism of resistance through molecular biology techniques and, in some cases, genetic sequencing. Since trauma is a gateway to bacterial infections, there is an increasing number of reports of antimicrobial resistant agents and that these elements have a considerable economic impact on the Brazilian Unified Health System (SUS),it is necessary to deepen this relation to the community as a whole. In this context The Municipal Hospital of São José dos Campos is considered a reference in trauma care for the municipality and region of the Paraíba Valley. It has about 318 beds, of which 38 belong to three Intensive Care Units (ICUs). This study includes all 1621 patients admitted for the first time in one of the 3 ICUs of the Municipal Hospital of São José dos Campos during the period from May 1, 2017 to August 31, 2018. Thus this study aims to: (I) identify the epidemiological and clinical characteristics of the population hospitalized in intensive care units with multidrug-resistant bacteremia (MDR); in this case, bloodstream infection by carbapenem-resistant enter bacteria, S. aureus to methicillin, vancomycin resistant Enterococcus sp; Resistance to carbapenems and carbapenem resistant A. baumannii; (II) To identify the risk factors for bacteremia caused by multidrug resistant agents in the population hospitalized for trauma; (III) To identify the resistance mechanisms of MDR strains; and (IV) to evaluate a clonally of these MDR strains.