Aplicação de um sistema de vigilância de infecções de corrente sanguínea em crianças acompanhadas na Unidade de Hemodiálise Pediátrica do Hospital São Paulo
Background: Hemodialysis vascular access infections are a great concern in children with end stage renal disease because in the majority of the pediatric population a venous catheter is used for the initiation of hemodialysis. Methods: From October 2006 to April 2009, the bloodstream infection surve...
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| Formato: | tesis de maestría |
| Estado: | Versión publicada |
| Fecha de publicación: | 2010 |
| País: | Brasil |
| Recursos: | Universidade Federal de São Paulo (UNIFESP) |
| Repositorio: | Repositório Institucional da UNIFESP |
| Idioma: | portugués |
| OAI Identifier: | oai:repositorio.unifesp.br:11600/8962 |
| Acesso em linha: | https://repositorio.unifesp.br/handle/11600/8962 |
| Access Level: | acceso abierto |
| Palavra-chave: | Child Hemodialysis Infection Surveillance Renal dialysis Criança Hemodiálise Infecção Vigilância Diálise renal |
| Resumo: | Background: Hemodialysis vascular access infections are a great concern in children with end stage renal disease because in the majority of the pediatric population a venous catheter is used for the initiation of hemodialysis. Methods: From October 2006 to April 2009, the bloodstream infection surveillance system proposed by the Centers for Disease Control and Prevention was prospectively conducted in a pediatric outpatient hemodialysis unit. Results: Thirty pediatric patients were included. Male gender was predominant and mean age was 9.5 years. Most patients (73%) had a catheter for vascular access at study entry. While the mean permanent catheter duration was 170.6 days, it was 2.2 years for fistulas. The main reasons for catheter removal were mechanical problems and infection. During the period of study, one in three patients were hospitalized each month and 20% of them died. We reported 181 events and 450 patients-month. The rate of vascular access infection was 21.1 per 100 patients-month, 16.7 per 100 patients-month for patients on temporary catheters and 30 per 100 patients-month for those on permanent catheters. Staphylococcus aureus was the microorganism most frequently identified, having been isolated in 34% of the blood samples. Conclusions: Our study showed different results than what is observed in adult patients, with higher rates of vascular access infection in children. The use of this surveillance system will help identify and monitor local infection rates, implement strategies for preventing vascular access infection and evaluate the effectiveness of interventions to prevent infections in the pediatric population on hemodialysis. |
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