Avaliação do Perfil de Resistência Microbiana de Infecções Relacionadas à Assistência à Saúde em um Hospital Universitário

Abstract

Healthcare-associated infections (HAIs) represent one of the main challenges for patient safety, especially given the increasing prevalence of antimicrobial resistance, which limits therapeutic options, increases length of stay, mortality, and hospital costs. Monitoring the resistance profile of microorganisms is essential to support prevention policies and the rational use of antibiotics. This study aimed to evaluate the antimicrobial resistance profile associated with HAIs in a university hospital, characterizing the prevalence, the microorganisms isolated, and the pattern of antimicrobial susceptibility. This was a prospective, quantitative observational cohort study conducted in a university hospital with patients hospitalized for more than 48 hours, over 18 years of age, between 2023 and 2025. The study included a sample of 487 patients. Of these, 144 developed HAIs and 72 had valid antibiograms. A predominance of Gram-negative bacilli, such as Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa, was observed, in addition to high rates of resistance to fluoroquinolones, β-lactams, and trimethoprim-sulfamethoxazole. The presence of multidrug-resistant microorganisms was identified in 37.5% of cases, associated with a higher proportional mortality rate. The most prevalent topography of healthcare-associated infections (HAIs) was urinary tract infection (22.2%), caused by surgical site infection (17.4%) and bloodstream infection (16.0%). The distribution by inpatient units showed a concentration of cases in the medical clinic (46.5%), followed by the ICU (23.6%), surgical clinic (16.0%), oncology clinic (9.7%), and ALCON (4.2%). Of the total patients, 74 died (14.9%). It is concluded that continuous monitoring of the microbiological profile and strengthening institutional strategies, especially those involving the nursing team, are fundamental to reducing the incidence of healthcare-associated infections (HAIs) and promoting safer care.