| Resumo: | Healthcare Associated Infection (HAI) are a major public health problem affecting 4 million patients per year in Europe and contribute increase the costs associated with healthcare. Cathether related bloodstream infections (CRBSI) are an important group of HAIs registering high incidence (87%) and mortality rates (23%) particulary in intensive care units (ICUs). In this work, an observational prospective study aiming at documenting the occurrence of CRBSI in three hospitals in Lisbon was performed. The study has been ongoing for 2 years and have identified 40 cases of CRBSI. The etiological agent, health unit, patient and central venous catheter (CVC) were characterized. The majority of the CRBSI (92.5%) have as etiological agent a bacterium resistant to at least one antibiotic (28/37); however, 3 cases (7.5%) of Candida spp. infections were identified. Two cases of infection are due to 2 bacteria. It should be noted that 67% of the infections are caused by staphylococci, of which 55.6% are coagulase negative (14 S. epidermidis and 1 S. haemolyticus) and 44.4% coag positive (12 S. aureus). It was not possible to associate a particular microorganism with one of the 3 hospitals. This may be due, in part, to sample dimension. The distribution of cases according to the inpatient service was as follows: intensive care units (35%), medical specialties (32.5%), surgical specialties (17%), general surgery (10%) and internal medicine (5%). The adults (mean age 58 years: 14/40) and the elderly (mean age 74 years: 22/40) were the age groups with the highest number of cases. The remainder were recorded in newborns (<1 month: 2/40) and young adults (2/40). More than half of the CVCs were inserted into the patient's jugular and remained there for less than 4 weeks (75%). The results obtained demonstrate that coagulase negative staphylococci are major players in CRBSI and antibiotic resistance. Cases due to more than one etiological agent may be associated with colonization of CVCs by biofilms. This aspect is being investigated by researching these structures in the CVCs. The collection of more data and its statistical treatment will allow to establish / exclude possible relationships between the different factors that determine the establishment of HAI. This, together with a greater knowledge of the etiological agents resulting from the sequencing of its genome, will increase our knowledge and, in the long term, establish more effective methods of control and prevention of HAIs.
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