Incidência de infecção do trato urinário relacionada ao uso do cateter urinário de demora em centros de terapia intensiva: comparação entre duas técnicas de limpeza periuretral

Abstract

CAMPOS, C. C. Incidence of indwelling catheter related urinary tract infection in intensive care units: comparison of two periurethral cleaning techniches. 2014. Dissertation (Master Degree in Health and Nursing) Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, 2014. This work is a non - concurrent prospective cohort with information on 301 patients admitted to intensive care units from two large public hospitals of Belo Horizonte, Minas Gerais, between the months of July to December 2011. This study had as main objective compare the incidence of urinary tract infection in patients undergoing urinary indwelling catheterization in the periurethral cleaning was done using soap and water or antiseptic. As specific objectives, we sought to estimate the incidence of urinary tract infections in each hospital; identify possible risk factors for the occurrence of this infection; determine the association of these risk factors with urinary tract infection, as well as the identification of causative organisms of this infection. To achieve theproposed objectives, we analyzed data descriptively and then there was the calculation of incidence density. To verify the association of the variables collected with urinary tract infection logistic regression was performed. Of the 301 patients, 21 developed the infection, 52.38 % being male and over the age of 60. The overall incidence was 6.34 infections/1000 catheter - days. Comparing the two hospitals, the hospital that used soap and water to clean the periurethral showed higher incidence than that used hospital antiseptic, 13, 69 infections/1000 catheters - day and 3.06 infections/1000 catheter-days, respectively. The identified risk factor was the use of the cleaning with soap and waterand length of stay in the ICU. The most prevalent microorganisms in the urine cultures was Candida sp.(23,80%), followed by the species of Escherichia coli, Pseudomonas aeruginosa e Klebsiella pneumoniae, presents in three urine cultures each (14,28%). This result contradicts the findings in the literature, and reinforces the need for primary studies that identify the safest solution for the realization of periurethral cleaning inorder to reduce the infection related to the use of urinary indwelling catheter urinary tract.