Existe relação entre a cultura de saliva e hemocultura para klebsiella spp. Em pacientes críticos?
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Data
2021-08-09
Autores
Santos, Leonardo Moura Brasil da Rocha [Unesp]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O impacto global do surgimento de bactérias multirresistentes leva a necessidade de maiores pesquisas para seu controle, vigilância, identificação, descolonização e novos tratamentos, com destaque para Klebsiella spp., devido sua importância clínica, virulência e alta prevalência. Pacientes de Unidades de Terapia Intensiva são mais vulneráveis a essa ameaça, necessitando medidas rígidas de controle, identificação precoce, profilaxias e tratamento. Dentro desse contexto uma estratégia é a utilização de culturas de sangue, urina, secreção traqueal, swab anal, axilar e nasal, para identificação do agente bacteriano, mas não é validado cultura de saliva, que por sua vez é meio de cultura para diversos tipos de bactérias, além da microbiota oral participa de diversos tipos fisiopatológicos como pneumonia de aspiração e endocardite mostrando sua disseminação pela corrente sanguínea, essas características conferem relevância clínica. A proposta desse trabalho é validar a cultura de saliva em ambiente de unidade de terapia intensiva determinando seu valor diagnóstico para infecção, sendo a metodologia usada análise estatística com busca de correlações dos resultados de hemoculturas e culturas de saliva proveniente do banco de dados do Serviço de Controle de Infecções Relacionadas à Assistência à Saúde de um hospital particular de São José dos Campos. Foram avaliados os resultados de cultura de vigilância do período de 16/01/2018 a 04/06/2021 totalizando 323 culturas pareadas entre saliva, secreção traqueal, sangue e urina provenientes de pacientes que estavam em mais de 5 dias de internação hospitalar e se encontravam na unidade de terapia intensiva. Foi analisado através de método estatístico a relação entre a presença de Klebsiella ssp. na cultura de saliva e hemocultura além correlacionando com dados de identificação, gravidade e desfecho. Sendo observado que a cultura de saliva infere os resultados de hemoculturas em relação Klebsiella spp em 0.25313 () (p 0,001) demonstrando que existe relação entre esses dois sítios de culturas.
The global impact of the emergence of multi-resistant bacteria leads to the need for further research for its control, surveillance, identification, decolonization and new treatments, with emphasis on Klebsiella spp., due to its clinical importance, virulence and high prevalence. Intensive Care Unit patients are more vulnerable to this threat, requiring strict control measures, early identification, prophylaxis and treatment. Within this context, a strategy is to use cultures of blood, urine, tracheal secretion, anal, axillary and nasal swab to identify the bacterial agent, but saliva culture is not validated, which in turn is a culture medium for different types. of bacteria, in addition to the oral microbiota participates in several pathophysiological types such as aspiration pneumonia and endocarditis showing its dissemination through the bloodstream, these characteristics confer clinical relevance. The purpose of this work is to validate the culture of saliva in an intensive care unit setting, determining its diagnostic value for infection, and the methodology used will be statistical analysis with the search for correlations of the results of blood cultures and saliva cultures from the Service's database. of Infection Control Related to Health Care at a private hospital in São José dos Campos. Surveillance culture results were obtained from 01/16/2018 to 06/04/2021, totaling 323 paired cultures between saliva, tracheal secretion, blood and urine from patients who had been hospitalized for more than 5 days and if found in the intensive care unit. The relationship between the presence of Klebsiella ssp. in saliva and blood cultures was analyzed using a statistical method, in addition to correlating with identification, severity and outcome data. Being observed that the saliva culture infers the results of blood cultures in relation to Klebsiella spp in 0.25313 () (p 0.001) demonstrated that there is a relationship between these two culture sites.
The global impact of the emergence of multi-resistant bacteria leads to the need for further research for its control, surveillance, identification, decolonization and new treatments, with emphasis on Klebsiella spp., due to its clinical importance, virulence and high prevalence. Intensive Care Unit patients are more vulnerable to this threat, requiring strict control measures, early identification, prophylaxis and treatment. Within this context, a strategy is to use cultures of blood, urine, tracheal secretion, anal, axillary and nasal swab to identify the bacterial agent, but saliva culture is not validated, which in turn is a culture medium for different types. of bacteria, in addition to the oral microbiota participates in several pathophysiological types such as aspiration pneumonia and endocarditis showing its dissemination through the bloodstream, these characteristics confer clinical relevance. The purpose of this work is to validate the culture of saliva in an intensive care unit setting, determining its diagnostic value for infection, and the methodology used will be statistical analysis with the search for correlations of the results of blood cultures and saliva cultures from the Service's database. of Infection Control Related to Health Care at a private hospital in São José dos Campos. Surveillance culture results were obtained from 01/16/2018 to 06/04/2021, totaling 323 paired cultures between saliva, tracheal secretion, blood and urine from patients who had been hospitalized for more than 5 days and if found in the intensive care unit. The relationship between the presence of Klebsiella ssp. in saliva and blood cultures was analyzed using a statistical method, in addition to correlating with identification, severity and outcome data. Being observed that the saliva culture infers the results of blood cultures in relation to Klebsiella spp in 0.25313 () (p 0.001) demonstrated that there is a relationship between these two culture sites.
Descrição
Palavras-chave
Klebsiella spp., Saliva, Hemocultura, Resistencia a múltiplos medicamentos, Cuidados críticos, Terapia Intensiva, Klebsiella spp, Saliva, Blood culture, Drug resistence, Critical illnes, Intensive care