Fatores de risco relacionados às infecções associadas à assistência à saúde de pacientes oncológicos internados no Hospital Universitário Professor Alberto Antunes

Abstract

Cancer occurs in complex health treatments that can lead to a hospitalization process that contributes to the emergence of Healthcare-Associated Infections (HAIs), culminating in increased mortality and decreased patient safety and the quality of health services provided, in addition to contributing to increased costs of these services. Objective: to evaluate the risk factors associated with HAIs in patients hospitalized at the Alberto Antunes University Hospital. Method: This was an observational, prospective cohort study with a quantitative approach. The sample consisted of 33 patients admitted to the Oncology Clinic for more than 48 hours, who agreed to participate in the study and authorized access to their medical records. The data were tabulated in RedCap and analyzed in Jamovi version 1.8.1. The data were described using absolute and relative frequencies. The association between HAIs and risk factors was assessed using the chi-square test or Fisher's exact test, and the odds ratio was calculated to assess the magnitude of the association. In all tests, a significance level of 5% was considered. Results: Of the 33 patients in the oncology clinic evaluated during the period from September 2023 to November 2024, eight had HAIs, of which eight (100%) were hospitalized for more than 15 days, five (71.4%) were hypertensive, four (50%) were ex-smokers, and seven (87.5%) used peripheral venous catheters. Bacterial culture was also performed in four of the eight patients with HAIs, and the following microorganisms were isolated: Klebsiella Pneumoniae, Escherichia coli, Staphylococcus Aureus, and Morganella morganii i. The results of the antibiograms of these microorganisms identified a common resistance profile to the following antibiotics: four (100%) were resistant to Ampicillin and three (75%) to Cephalexin, Levofloxacin, Trimethoprim, and Sulfamethoxazole. The resistance presented by Morganella morganii to Imipenem stands out. Conclusion: HAIs affected patients under 60 years of age, with excess weight, three of whom were overweight and two with grade I obesity, with hypertension, former smokers, who used peripheral venous catheters. The topographies of the prevalent HAIs were: Primary bloodstream infection and urinary tract infection, in which the isolated microorganisms presented a resistance profile to several classes of antimicrobials, including broad-spectrum antibiotics such as ampicillin, piperacillin-tazobactam and imipenem. Therefore, given the profile of the patients presented, the aggravating factors and the main topographies of HAIs identified in the oncology clinic, it is necessary to implement measures to prevent and control HAIs and rational use of antimicrobials, as well as the need to perform culture exams and antibiograms among patients.