Infecção da corrente sanguínea

Summary

In this informative video, Nurse Tamires Leite discusses bloodstream infections (BSI) in oncology patients, focusing on infections related to central venous catheters (CVCs). She explores the epidemiology, risk factors, and preventive measures, with emphasis on evidence-based guidelines for infection control. The video highlights the differences in infection types between countries, particularly the prevalence of resistant gram-negative bacteria in Brazil. Key recommendations are shared for preventing BSI before, during, and after catheter insertion, as well as diagnostic criteria and surveillance strategies. This video serves as a vital resource for healthcare professionals in oncology and intensive care settings.

Takeaways

• 😀 Bloodstream infections (BSI) are a major concern in oncology patients due to the use of vascular access devices and their immunocompromised state.
• 🩺 The main pathogens causing BSIs in the USA are gram-positive cocci and Candida, while in Brazil, gram-negative bacteria like *Acinetobacter* and *Escherichia coli* are more prevalent.
• 📊 Mortality rates for bloodstream infections in Brazil can reach up to 40%, compared to 12-25% in the USA.
• 💉 Neutropenia is a significant risk factor for BSIs in cancer patients due to their weakened immune systems.
• 🦠 Diagnosis of BSI relies on identifying a pathogen in a hemoculture and ruling out other infection sources, with the presence of a central vascular access device being a key indicator.
• 🚨 Diagnostic criteria for BSI include a positive hemoculture, fever or hypotension, and the presence of a vascular device for more than 10 days.
• 👨‍⚕️ Strict infection prevention measures must be followed during the insertion and maintenance of central venous catheters (CVC) to minimize infection risks.
• 🧴 Using chlorhexidine for daily baths and aseptic techniques during catheter insertion is critical for reducing infection rates, especially in ICU patients.
• 🔬 Ultrasound-guided insertion of CVCs and the use of subclavian access can further reduce infection risk.
• 📅 Catheter hubs and dressings should be regularly disinfected, with transparent, antimicrobial dressings being recommended for effective prevention of BSI.

Q & A

What is the main focus of the video discussed in the transcript?

The video focuses on bloodstream infections (BSIs) in oncology patients, particularly the epidemiology, risk factors, prevention strategies, and diagnostic criteria for these infections, with an emphasis on infection control in healthcare settings.

What are the primary causes of bloodstream infections in the U.S. compared to Brazil?

In the U.S., the primary causes of bloodstream infections are gram-positive cocci and *Candida*, while in Brazil, the leading causes are gram-negative bacilli like *Acinetobacter* and *Klebsiella*, which are also more resistant to carbapenem antibiotics.

Why are oncology patients at higher risk for bloodstream infections?

Oncology patients are at higher risk for bloodstream infections due to factors like neutropenia (low white blood cell count), the frequent use of vascular access devices, and their need for treatments like chemotherapy, which weaken their immune system.

What is a key factor in preventing bloodstream infections during the insertion of a central venous catheter (CVC)?

A key factor in preventing infections during CVC insertion is ensuring that the procedure follows strict aseptic techniques, including the use of a checklist, proper hand hygiene, and potentially using ultrasound for guided insertion.

How can bloodstream infections be diagnosed in patients with vascular access devices?

Bloodstream infections can be diagnosed by identifying a pathogen in a hemoculture, along with clinical signs like fever or hypotension, and confirming the presence of a vascular access device for at least 10 days.

What role does neutropenia play in the risk of bloodstream infections in oncology patients?

Neutropenia, a condition where the body has a low count of neutrophils (a type of white blood cell), significantly increases the risk of bloodstream infections in oncology patients by impairing their immune response to pathogens.

What measures should be taken before the insertion of a central venous catheter (CVC)?

Before CVC insertion, it's important to have a clear list of indications for different types of vascular access, ensure that healthcare professionals are trained in proper techniques, and perform daily cleansing of the patient with antiseptic solutions like chlorhexidine, especially in intensive care units.

What is the significance of using chlorhexidine in infection prevention strategies for oncology patients?

Chlorhexidine plays a crucial role in preventing infections by reducing microbial load on the patient's skin, especially before catheter insertion. It is recommended for use in daily baths for patients in intensive care settings to reduce infection risks.

What are the key post-insertion recommendations for preventing bloodstream infections?

Post-insertion recommendations include ensuring adequate staffing levels, limiting staff rotation, using impregnated dressings with chlorhexidine, and regularly changing dressings and infusion lines, particularly in high-risk settings like intensive care units.

What is the role of the 'checklist' mentioned during catheter insertion?

The checklist serves as a tool to ensure that all infection prevention steps are followed during the insertion of a central venous catheter, helping reduce the likelihood of errors or missed steps in the aseptic process.