Perfil epidemiológico das infecções do trato urinário em gestantes de um hospital universitário de Curitiba
Tipo
TCC
Data de publicação
2024-11-28
Periódico
Citações (Scopus)
Autores
Lima, Douglas Felipe Silva
Basso, Geórgia Travaglia
Basso, Geórgia Travaglia
Orientador
Rossoni, Andrea Maciel de Oliveira
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ISSN da Revista
Título de Volume
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Introdução: mudanças anatômicas e fisiológicas da gestação predispõem a infecções do trato urinário (ITU), que demandam cuidados especiais nesse período devido à associação com maior morbimortalidade materno-fetal. Assim, diagnóstico e tratamento precoces e corretos são essenciais nessa população, e para isso, conhecer os padrões epidemiológicos é fundamental. Objetivo: traçar o perfil epidemiológico das infecções do trato urinário em gestantes de um hospital universitário de Curitiba, Paraná, Brasil. Método: o estudo foi observacional, descritivo, analítico e transversal com coleta de dados retrospectiva em 1000 prontuários médicos de parturientes do Hospital Universitário Evangélico Mackenzie (HUEM) atendidas entre janeiro de 2020 e dezembro de 2023. Foram analisados idade, idade gestacional, paridade, tipo de parto e dados do recém-nato (peso ao nascimento e escores de APGAR aos 1º e 5º minutos), além da ocorrência ou não de infecção urinária, patógeno encontrado e diagnóstico clínico a partir de testes estatísticos que demonstrem a significância ou não dessas associações. Resultados: a prevalência de ITU na gestação foi de 15,5% com incidências significativamente maiores em mulheres mais jovens e primigestas e sem relações significativas com idade gestacional, tipo de parto e avaliação do recém-nato. Além disso, a idade gestacional média foi de 38 semanas e 4 dias, o peso médio dos recém-nascidos foi de 3136 gramas e os escores de APGAR foram mais altos em partos normais. As bactérias mais encontradas em uroculturas foram E. coli, Enterococcus faecalis e do grupo KPC, havendo resistência principalmente à ampicilina. Conclusão: A prevalência menor que a literatura brasileira pode ser reflexo do cuidado em alto risco gestacional do serviço analisado, fator que também influencia o desfecho gestacional não ter diferenças significativas na ocorrência ou não de ITU. Primigestas e gestantes mais jovens apresentaram mais infecções urinárias na gestação, reiterando a literatura mundial. Escherichia coli é o agente etiológico mais comum no mundo, e a resistência antimicrobiana é um desafio no manejo dessas infecções.
Introduction: Anatomical and physiological changes during pregnancy predispose to urinary tract infections (UTIs), which require special care during this period due to their association with increased maternal and fetal morbidity and mortality. Therefore, early and correct diagnosis and treatment are essential in this population, and for this, knowledge of epidemiological patterns is fundamental. Objective: to outline the epidemiological profile of urinary tract infections in pregnant women at a university hospital in Curitiba, Paraná, Brazil. Method: this was an observational, descriptive, analytical, and cross-sectional study with retrospective data collection from 1,000 medical records of parturients at the Hospital Universitário Evangélico Mackenzie (HUEM) treated between January 2020 and December 2023. Age, gestational age, parity, type of delivery, and newborn data (birth weight and 1st and 5th minute APGAR scores) were analyzed, in addition to the occurrence or not of urinary tract infection, pathogen found, and clinical diagnosis based on statistical tests that demonstrate the significance or not of these associations. Results: the prevalence of UTI during pregnancy was 15.5%, with significantly higher incidences in younger and primigravida women and no significant relationships with gestational age, type of delivery, and newborn assessment. Furthermore, the mean gestational age was 38 weeks and 4 days, the mean weight of newborns was 3136 grams, and APGAR scores were higher in normal deliveries. The most common bacteria found in urine cultures were E. coli, Enterococcus faecalis, and KPC group, and resistance was mainly to ampicillin. Conclusion: the prevalence lower than that reported in Brazilian literature may reflect the high-risk pregnancy care provided by the service analyzed, a factor that also influences the gestational outcome, as there were no significant differences in the occurrence or absence of UTI. Primigravidae and younger pregnant women had more urinary tract infections during pregnancy, which is consistent with the worldwide literature. Escherichia coli is the most common etiological agent in the world, and antimicrobial resistance is a challenge in the management of these infections.
Introduction: Anatomical and physiological changes during pregnancy predispose to urinary tract infections (UTIs), which require special care during this period due to their association with increased maternal and fetal morbidity and mortality. Therefore, early and correct diagnosis and treatment are essential in this population, and for this, knowledge of epidemiological patterns is fundamental. Objective: to outline the epidemiological profile of urinary tract infections in pregnant women at a university hospital in Curitiba, Paraná, Brazil. Method: this was an observational, descriptive, analytical, and cross-sectional study with retrospective data collection from 1,000 medical records of parturients at the Hospital Universitário Evangélico Mackenzie (HUEM) treated between January 2020 and December 2023. Age, gestational age, parity, type of delivery, and newborn data (birth weight and 1st and 5th minute APGAR scores) were analyzed, in addition to the occurrence or not of urinary tract infection, pathogen found, and clinical diagnosis based on statistical tests that demonstrate the significance or not of these associations. Results: the prevalence of UTI during pregnancy was 15.5%, with significantly higher incidences in younger and primigravida women and no significant relationships with gestational age, type of delivery, and newborn assessment. Furthermore, the mean gestational age was 38 weeks and 4 days, the mean weight of newborns was 3136 grams, and APGAR scores were higher in normal deliveries. The most common bacteria found in urine cultures were E. coli, Enterococcus faecalis, and KPC group, and resistance was mainly to ampicillin. Conclusion: the prevalence lower than that reported in Brazilian literature may reflect the high-risk pregnancy care provided by the service analyzed, a factor that also influences the gestational outcome, as there were no significant differences in the occurrence or absence of UTI. Primigravidae and younger pregnant women had more urinary tract infections during pregnancy, which is consistent with the worldwide literature. Escherichia coli is the most common etiological agent in the world, and antimicrobial resistance is a challenge in the management of these infections.
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Palavras-chave
prematuridade , sepse na gestação , farmacorresistência bacteriana , premature , infant , pregnancy complications , infectious , drug resistance , bacterial