Sepse bacteriana: fisiopatologia e epidemiologia no Brasil
Nenhuma Miniatura disponível
Data
2023-12
Tipo de documento
Artigo Científico
Título da Revista
ISSN da Revista
Título de Volume
Área do conhecimento
Modalidade de acesso
Acesso fechado
Editora
Autores
MACHADO, Daiane Consorte
Orientador
QUATRIN, Priscilla Maciel
Coorientador
Resumo
A sepse é uma doença complexa e grave, atualmente é considerada uma disfunção orgânica com risco de vida causada por uma resposta desregulada do hospedeiro à infecção. A patogênese da síndrome depende da ativação da resposta imune inata, que desempenha um papel direto no desenvolvimento da sepse. Diferentes biomarcadores são utilizados para diagnóstico sepse e no estágio de bacteremia, são administrados antimicrobianos, ocasionando a morte bacteriana; porém, patógenos isolados podem resistir causando a Síndrome da Resposta Inflamatória Sistêmica. O perfil de resistência aos antimicrobianos está diretamente ligado aos aspectos microbiológicos das bactérias. Staphylococcus aureus e Escherichia coli são as principais bactérias envolvidas com quadros de sepse, e representam mais de 50% dos casos. A antibioticoterapia endovenosa, de amplo espectro é recomendada para pacientes com sepse ou choque. No Brasil, a taxa de mortalidade é de 55,7% segundo o estudo SPREAD e o que contrasta com 45% observados em outros países em desenvolvimento e 38,2% em países desenvolvidos. Durante as últimas décadas, houve uma série de descobertas sobre a patogênese, prevenção e estratégias terapêuticas, no entanto, a prevalência de sepse, principalmente a de origem bacteriana, continua colaborando para que as taxas de mortalidade permaneçam altas.
Sepsis is a complex and serious disease, currently considered a life-threatening organ dysfunction caused by a dysregulated host response to infection. The pathogenesis of the syndrome depended on the activation of the innate immune response, which plays a direct role in the development of sepsis. Different biomarkers are used for diagnosis of sepsis and not stage of bacteremia, antimicrobials are administered, causing bacterial death; however, isolated pathogens may resist causing a Systemic Inflammatory Response Syndrome. The antimicrobial resistance profile is directly linked to the microbiological aspects of bacteria. Staphylococcus aureus and Escherichia coli are the main bacteria involved in sepsis and represent more than 50% of cases. Broad-spectrum intravenous antibiotic therapy is recommended for patients with sepsis or shock. In Brazil, the mortality rate is 55.7% according to the SPREAD study, which contrasts with the 45% observed in other developing countries and 38.2% in integrated countries. During the last decades, there have been a series of discoveries about the pathogenesis, prevention, and therapeutic strategies, however, the prevalence of sepsis, mainly of bacterial origin, continues to contribute to the suppression of high mortality rates.
Sepsis is a complex and serious disease, currently considered a life-threatening organ dysfunction caused by a dysregulated host response to infection. The pathogenesis of the syndrome depended on the activation of the innate immune response, which plays a direct role in the development of sepsis. Different biomarkers are used for diagnosis of sepsis and not stage of bacteremia, antimicrobials are administered, causing bacterial death; however, isolated pathogens may resist causing a Systemic Inflammatory Response Syndrome. The antimicrobial resistance profile is directly linked to the microbiological aspects of bacteria. Staphylococcus aureus and Escherichia coli are the main bacteria involved in sepsis and represent more than 50% of cases. Broad-spectrum intravenous antibiotic therapy is recommended for patients with sepsis or shock. In Brazil, the mortality rate is 55.7% according to the SPREAD study, which contrasts with the 45% observed in other developing countries and 38.2% in integrated countries. During the last decades, there have been a series of discoveries about the pathogenesis, prevention, and therapeutic strategies, however, the prevalence of sepsis, mainly of bacterial origin, continues to contribute to the suppression of high mortality rates.
Palavras-chave
sepse, bacteremia, antimicrobianos, Staphylococcus aureus, Escherichia coli