1 - Unidade de Infecciologia Pediátrica, Área de Pediatria, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
2 - Departamento de Microbiologia, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
- Reunião internacional (ESPID)
Resumo:
Introdução: The production of extended-spectrum β-lactamase (ESBL) is one of the main mechanisms of Enterobacteriaceae antibiotic resistance. Resistance responsible genes are encoded into plasmids that can rearrange between themselves, making these gram-negative bacteria challenging to treat.
Objectivos: Enterobacteriaceae colonization in incoming patients from portuguese-speaking african countries (PSAC) in a tertiary paediatric hospital.
Métodos: Descriptive analysis of patients incoming from PSAC with culture-based detection of ESBL bacteria on colonization studies, between 2013 and 2019.
Resultados: In a total of 183 samples were reported 61/124 (49.2%) patients. The median age was 4 years (min-1month; max-16years), with 18 (30%) cases in 2017 and 27 (44%) cases in 2018. The country of origin form patients was Angola (17), São Tomé and Príncipe (16), Cape Verde (15), Guinea-Bissau (12) and Mozambique (1). The diagnosis was infectious diseases in 23 cases (38%), central nervous system pathology in 14 cases (23%) and tumor in 9 (15%). The more frequent risk factors were previous antibiotic treatment (36%) with unknown antibiotic status, and previous hospitalization (46%). Other risk factors were previous surgery or invasive procedure (36%), chronic wound (21%), immunodepression (10%) and dialysis (2%). Patients were treated with medium 2 antibiotics in home country and needed treatment with medium 3 antibiotics in our hospital. We also identified MRSA (1) and carbapenemase-producing (1) in two patients. Moreover, 6 cases of ESBL disease (9.8%) were reported out of 61 colonized patients. The length of stay of these patients was medium 27 days (min-1; max-461) of hospitalization.
Conclusões: Patients from PSAC have a significant number of ESBL colonized and are associated with long term hospitalizations and demanding antibiotic treatment strategies.
Palavras Chave: Enterobacteriaceae; Extended-spectrum β-lactamase; Portuguese-speaking african countries; Risk factors