Aplicação clínica da interpretação microbiológica de hemoculturas com crescimento de estafilococos coagulase-negativa
Palavras-chave:
Coagulase-negative staphylococci, blood culture, catheter-related infections, bacteremiaResumo
Nos últimos anos, tem sido descrita uma progressiva mudança dos
microorganismos responsáveis pelas infeções nosocomiais. Os
bacilos gram-negativos, que eram os principais microorganismos
responsáveis por infeções intrahospitalares, foram substituídos
por cocos gram-positivos, essencialmente, Staphylococcus aureus
e estafilococos coagulase-negativa (ECN). O aumento do número
de infeções estafilocócicas, especialmente associadas à utilização
de cateteres venosos periféricos ou centrais, ao uso da nutrição
parenteral e de pacemakers e materiais prostéticos, representa
um desafio importante para o médico. Uma vez que a maioria
destas infecções está associada com bacteremia e septicemia,
as hemoculturas representam um dos mais valiosos métodos
complementares para um rápido diagnóstico.
Neste artigo iremos rever os parâmetros microbiológicos mais
úteis que podem ser aplicados na interpretação do resultado
positivo de uma hemocultura (especialmente se um ECN é identificado). Explicaremos também de forma sucinta as diferentes
causas de bacteremia relacionada com cateteres e as diferentes
taxas de contaminação e infeção associadas com os vários dispositivos intravasculares percutâneos.
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