Infecção relacionada à assistência à saúde em unidade de terapia intensiva de um hospital privado em Mato Grosso do Sul

Abstract

Hospital Acquired Infection (HAI) is a worrying public health problem in all countries, and an important factor in the outcome of critical patients, with increased morbidity and mortality, the time and cost of hospitalization. In Brazil, studies evaluating costs associated with treatment HAI are limited. This research aimed to identify the sites and agents HAI, risk conditions and clinical outcomes of patients with and without HAI. In addition, compare direct treatment costs and length of stay among patients who acquired infection and those who have not acquired infection in intensive care unit (ICU) of a private hospital in Mato Grosso do Sul. Clinical and laboratory data of patients admitted from January 2010 to December 2011 were obtained from records of the Committee on hospital Infection Control (CCIH) and data relating to the costs of the financial sector of the hospital. Of the total 276 patients studied, 29.4% acquired nosocomial infection. The most common sites of infection were the lower respiratory tract (45; 55.6%), bloodstream (18; 22.2%) and urinary tract (12; 14.8%). The main agents of infection were: Staphylococcus aureus (16; 19.8%), Pseudomonas aeruginosa (13; 16%), Escherichia coli (12; 14.8%) and Klebsiella spp (7; 8.6%). Prolonged use of invasive devices such as mechanical ventilation, central venous catheter, urinary catheter, drain and tracheal intubation was considered statistically significant risk condition for the development of HAI. Patients with HAI were hospitalized an average of 14 days longer than those who have not contracted the infection and 32 patients (39.5%) with HAI died. The average cost spent on antibiotics was R$ 8,641.88 for the treatment of patients with HAI, 58 times higher than the amount spent with patients who have not acquired HAI. The average total amount spent on hospitalization of patients who had and not developed HAI was R$ 38,322.23 and R$ 1,492.50, respectively. This study shows that patients with nosocomial infection have higher ICU stay, which, in turn, raises the cost of treatment. The results contribute to the literature on acquisition-related costs of HAI and should motivate management and CCIH hospitals to implement measures to control and prevent these infections.