{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T05:13:05Z","timestamp":1784783585974,"version":"3.55.0"},"reference-count":48,"publisher":"Ordem dos Medicos","issue":"1","license":[{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Med Port"],"abstract":"<jats:p>Introdu\u00e7\u00e3o: As infe\u00e7\u00f5es associadas aos cuidados de sa\u00fade s\u00e3o uma causa importante de morbimortalidade na popula\u00e7\u00e3o pedi\u00e1trica, representando um problema crescente nos servi\u00e7os de cuidados intensivos. Contudo, existem poucos estudos que caracterizam a realidade destas infe\u00e7\u00f5es na popula\u00e7\u00e3o pedi\u00e1trica portuguesa. Este estudo pretendeu avaliar a sua preval\u00eancia num servi\u00e7o de cuidados intensivos pedi\u00e1trico portugu\u00eas, identificando os microrganismos mais frequentes e o respetivo perfil de resist\u00eancia aos antibi\u00f3ticos.M\u00e9todos: Estudo de coorte retrospetivo que incluiu os doentes admitidos num servi\u00e7o de cuidados intensivos pedi\u00e1trico entre 1 de janeiro de 2014 e 31 de dezembro de 2023, com diagn\u00f3stico de infe\u00e7\u00f5es associadas aos cuidados de sa\u00fade durante o internamento.Resultados: Identificaram-se 248 casos, correspondendo a uma preval\u00eancia de 6,3%, a maioria em lactentes. As infe\u00e7\u00f5es mais frequentes forampneumonia (45,2%) e bacteriemia (14,5%), sendo os agentes infeciosos mais comuns os Gram negativos, nomeadamente a Escherichia coli, a Pseudomonasaeruginosa e a Klebsiella pneumoniae. Observou-se um aumento global das resist\u00eancias antibi\u00f3ticas nos \u00faltimos cinco anos (2019 - 2023). A taxa de infe\u00e7\u00e3o por bact\u00e9rias produtoras de ESBL, MRSA e ERC foi, respetivamente, 8,5%, 1,6% e 0,4%, superior nos anos 2019 - 2023. Houve 45 coloniza\u00e7\u00f5es em 41 doentes (num total de 97 pesquisas realizadas): 40 a ESBL e 5 a ERC (sem coloniza\u00e7\u00f5es por MRSA). A s\u00e9psis ocorreu em 29,8% casos e a mortalidade foi de 11,7% (4,0% devido \u00e0 IACS). A exposi\u00e7\u00e3o a tubo endotraqueal e a ventila\u00e7\u00e3o invasiva de longa dura\u00e7\u00e3o associaram-sea maior probabilidade de desenvolver pneumonia (OR = 2,5; IC 95%, 1,1 a 5,9; p = 0,03; e OR = 1,9; IC 95%, 1,1 a 3,4; p = 0,011; respetivamente).Conclus\u00e3o: \u00c9 fundamental implementar estrat\u00e9gias eficazes para prevenir e controlar a dissemina\u00e7\u00e3o das bact\u00e9rias resistentes, assegurando a efic\u00e1cia das terap\u00eauticas atuais, a seguran\u00e7a dos doentes e a prote\u00e7\u00e3o da sa\u00fade p\u00fablica.<\/jats:p>","DOI":"10.20344\/amp.22279","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T11:44:13Z","timestamp":1735818253000},"page":"23-36","source":"Crossref","is-referenced-by-count":4,"title":["Infe\u00e7\u00f5es Associadas aos Cuidados de Sa\u00fade em Idade Pedi\u00e1trica: 10 Anos de Experi\u00eancia num Servi\u00e7o de Cuidados Intensivos"],"prefix":"10.20344","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5990-7203","authenticated-orcid":false,"given":"C\u00e1tia","family":"Martins","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0467-4036","authenticated-orcid":false,"given":"Daniela","family":"Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1556-9737","authenticated-orcid":false,"given":"Mariana","family":"Cortez Ferreira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7128-2821","authenticated-orcid":false,"given":"Joana","family":"Verdelho Andrade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5102-5388","authenticated-orcid":false,"given":"Andrea","family":"Dias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"8464","published-online":{"date-parts":[[2025,1,2]]},"reference":[{"key":"7786","doi-asserted-by":"crossref","unstructured":"Su C, Zhang Z, Zhao X, Peng H, Hong Y, Huang L, et al. 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The national rate of intensive care units-acquired infections, one-year retrospective study in Iran. BMC Public Health. 2021;21:609.","DOI":"10.1186\/s12889-021-10639-6"},{"key":"7790","doi-asserted-by":"crossref","unstructured":"Aktar F, Tekin R, G\u00fcne\u015f A, \u00dclgen C, Tan I, Ertu\u011frul S, et al. Determining the independent risk factors and mortality rate of nosocomial infections in pediatric patients. Biomed Res Int. 2016;2016:7240864.","DOI":"10.1155\/2016\/7240864"},{"key":"7791","doi-asserted-by":"crossref","unstructured":"Wang L, Du KN, Zhao YL, Yu YJ, Sun L, Jiang HB. Risk factors of nosocomial infection for infants in neonatal intensive care units: a systematic review and meta-analysis. Med Sci Monit. 2019;25:8213-20.","DOI":"10.12659\/MSM.917185"},{"key":"7792","doi-asserted-by":"crossref","unstructured":"Rangelova V, Kevorkyan A, Raycheva R, Krasteva M. Ventilatorassociated pneumonia in the neonatal intensive care unit-incidence and strategies for prevention. 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Risk factors for long-term invasive mechanical ventilation: a longitudinal study using German health claims data. Respiratory Research. 2024;25:60.","DOI":"10.21203\/rs.3.rs-2599890\/v1"},{"key":"7805","doi-asserted-by":"crossref","unstructured":"Teixeira H, Freitas A, Sarmento A, Nossa P, Gon\u00e7alves H, Pina MF. Spatial patterns in hospital-acquired infections in Portugal (2014-2017). Int J Environ Res Public Health. 2021;18:4703.","DOI":"10.3390\/ijerph18094703"},{"key":"7806","unstructured":"Andrade MH. Infe\u00e7\u00f5es Associadas aos cuidados de sa\u00fade numa unidade de cuidados intensivos pedi\u00e1tricos. Estudo comparativo 2013- 2020. Lisboa: Faculdade de Medicina da Universidade de Lisboa; 2021."},{"key":"7807","doi-asserted-by":"crossref","unstructured":"Uc-Cach\u00f3n AH, Gracida-Osorno C, Luna-Chi IG, Jim\u00e9nez-Guillermo JG, Molina-Salinas GM. High prevalence of antimicrobial resistance among gram-negative isolated bacilli in intensive care units at a tertiarycare hospital in Yucat\u00e1n Mexico. Medicina. 2019;55:588.","DOI":"10.3390\/medicina55090588"},{"key":"7808","unstructured":"European Centre for Disease Prevention and Control. Healthcareassociated infections acquired in intensive care units. Annual Epidemiological Report for 2020. 2024. [consultado 2024 jun 12]. Dispon\u00edvel em: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/ documents\/healthcare-associated-infections-intensive-care-unitsannual- epidemiological-report-2020.pdf."},{"key":"7809","doi-asserted-by":"crossref","unstructured":"Basnet S, Adhikari S, Jha J, Pandey MR. Neonatal intensive care unit admissions among preterm babies in a tertiary care centre: a descriptive cross-sectional study. 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Intensive Care Med. 2017;43:1097-104.","DOI":"10.1007\/s00134-017-4852-7"},{"key":"7819","unstructured":"Kohbodi GA, Rajasurya V, Noor A. Ventilator-associated pneumonia. In: StatPearls. Treasure Island: StatPearls Publishing LLC; 2024."},{"key":"7820","doi-asserted-by":"crossref","unstructured":"Kepenekli E, Soysal A, Yalindag-Ozturk N, Ozgur O, Ozcan I, Devrim I, et al. Healthcare-associated infections in pediatric intensive care units in Turkey: a national point-prevalence survey. Jpn J Infect Dis. 2015;68:381-6.","DOI":"10.7883\/yoken.JJID.2014.385"},{"key":"7821","doi-asserted-by":"crossref","unstructured":"Balkhy HH, El-Saed A, AlShehri A, Alshaalan M, Hijazi O, El-Metwally A, et al. Antimicrobial consumption in three pediatric and neonatal intensive care units in Saudi Arabia: 33-month surveillance study. 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