Resistência bacteriana no tratamento de pneumonia em pacientes de unidades hospitalares: uma revisão sistemática

Abstract

Objetivo: identificar quais são as principais bactérias resistentes a amplos medicamentos associadas ao desenvolvimento de pneumonia em pacientes de unidades hospitalares no período de 2017 a 2022 a nível mundial, comparando os agentes identificados antes e durante a pandemia devido a COVID-19. Metodologia: A pesquisa dos artigos foi realizada nas bases de dados Scielo, PubMed e UpToDate, sendo utilizadas as normas do Preferred ReportingItems for Systematic Reviews and Meta-Analyses (PRISMA). A estratégia ‘’PVOS’’ (population, variables, outcomes and study) foi utilizada para selecionar os artigos analisados na revisão. Foram utilizados os descritores padronizados pelos ‘’Descritores em Ciências da Saúde’’: pneumonia, antibacterianos, farmacorresistência bacteriana, farmacorresistência bacteriana múltipla para o levantamento bibliográfico. Foram incluídos nessa revisão sistemática estudos observacionais analíticos, artigos de pesquisa publicados, estudos de caso, revisões sistemáticas e estudos de vigilância epidemiológica, microbiológica, e molecular. Resultados: Após o processo de triagem, remoção de artigos duplicados e análises dos critérios de inclusão, 27 artigos foram identificados como elegíveis para esta revisão sistemática. Conclusão: Os resultados desta revisão sistemática fornecem evidências das principais bactérias causadoras de pneumonia em pacientes hospitalizados a nível mundial, bem como o perfil de resistência em caso de organismos multirresistentes, além de identificar alternativas de tratamento para esses agentes.

A Retrospective Cohort Analysis of the Treatment of Bacterial Pneumonia Pediatric Cases

“…The organized protocols must follow what is recommended by the Ministry of Health and updated studies in the area, considering the pathology and the age group being treated, but must, mainly, consider the epidemiology of the region, in order to avoid the unnecessary prescription of antibiotics, which, as it is an infectious disease, has the possibility of developing resistant bacteria, which are associated with greater clinical complications. Thus, the studies show, as well as the results found, that following the norms and protocols are associated with greater effectiveness of the treatment [18,19].…”

Antimicrobial resistance of Pseudomonas aeruginosa isolated from patients with pneumonia during the COVID-19 pandemic and pre-pandemic periods in Northeast Brazil

“…Healthcare-associated infections (HAIs) caused by resistant microorganisms are becoming increasingly prevalent, especially in the hospital environment (1), considered a site for opportunistic and virulent pathogens. However, this resistance challenge has surpassed the limits of hospitals (2).…”

“…In the hospital environment, infections are acquired after admission and may manifest during a hospital stay or after discharge (2,6), directly affecting the hospitalization process, especially in intensive care units (ICU). This occurs because ICU patients are more susceptible to several infections due to extended hospital stays, more invasive procedures, and an immunocompromised system with multiple drug use and associated comorbidities (6).…”

“…aeruginosa is commonly associated with more severe disease because it is an opportunistic microorganism, especially for patients with compromised immune systems (8). It is among the bacteria most commonly associated with hospital-acquired infections and ventilator-associated pneumonia (VAP) (2,9), and according to the WHO, in 2017, P. aeruginosa was considered a critical priority pathogen resistant to carbapenems, due to its multidrug resistance (10).…”

“…Furthermore, pneumonia is the main health care-related infection and affects mainly patients with endotracheal intubation and mechanical ventilation (2,13). About 10 to 20% of these patients develop pneumonia with a high mortality rate (13).…”