OMS aponta: sepse soma 11 milhões de óbitos e 20% de todas as mortes globais
por Lucia Nunes – sistemas@mailingimprensa.com.br
Dia 13 de setembro é celebrado o Dia Mundial de Prevenção da Sepse. Este ano, a SOBRASP – Sociedade Brasileira para a Qualidade do Cuidado e Segurança do Paciente – destaca a importância da prevenção da sepse em recém-nascidos e crianças. No Brasil, segundo dados preliminares de 2024 do Ministério da Saúde, por meio do Sistema de Informações Hospitalares (SIH) do SUS, foram registrados 7,7 mil atendimentos por sepse em recém-nascidos e 9,8 mil em crianças. No mesmo período, informações preliminares do Sistema de Informações sobre Mortalidade (SIM) apontam 2,7 mil óbitos infantis por septicemia no país.
No mundo, de acordo com os últimos dados da OMS, em 2020, foram registrados 48,9 milhões de casos e 11 milhões de mortes, representando 20% de todos os óbitos globais. Quase metade dos casos estimados de sepse ocorreu em crianças com menos de cinco anos (aproximadamente 20 milhões). A quantificação de casos no mundo é bem escassa, principalmente, em países com médio e baixos recursos. Estima-se que cerca de 85% dos casos ocorram nesses locais.
A sepse é uma das principais causas de morte evitável nos hospitais. “O diagnóstico precoce e o manejo adequado são medidas decisivas para reduzir a mortalidade. A SOBRASP destaca que a identificação e o tratamento são parte fundamental das estratégias de segurança do paciente em todo o país”, comenta Claudia Vidal, infectologista e membro da SOBRASP.
A sepse é, geralmente, causada por infecções bacterianas, mas pode resultar de outras infecções, como vírus, parasitas ou fungos. Na maioria dos casos, é adquirida em ambientes de assistência à saúde, sendo as Infecções relacionadas à Assistência à Saúde (IRAS), um dos eventos adversos mais frequentes durante a prestação de cuidados. As infecções associadas à assistência à saúde são provocadas por patógenos frequentemente resistentes a antimicrobianos e podem levar rapidamente à piora das condições clínicas. A resistência antimicrobiana é um fator importante que dificulta a resposta clínica ao tratamento e acelera a evolução para sepse e choque séptico. Pacientes com sepse e patógenos, de difícil combate, apresentam maior risco de mortalidade hospitalar.
Quem está mais suscetível à sepse? Pode afetar qualquer pessoa, mas os idosos, grávidas, recém-nascidos, crianças, imunocomprometidos e pessoas com outros problemas de saúde têm maior risco.
Principais sintomas em recém-nascidos:
- Temperatura corporal instável (febre alta ou hipotermia).
- Muitas vezes o neonato pode apresentar apatia, irritabilidade, letargia, dificuldade para se alimentar e sucção reduzida.
- Atenção a sinais de circulação: pele fria, pálida ou manchas roxas e má perfusão periférica.
- Outros sintomas podem incluir vômitos, diarreia, inchaço na barriga e icterícia (amarelamento da pele e dos olhos).
Principais sintomas em crianças:
- Temperatura corporal geralmente mais elevada.
- Possíveis vômitos e diarreia persistentes, redução na quantidade de urina, confusão, tontura e desconforto extremo.
- Respiração rápida, dificuldade para respirar ou sensação de falta de ar.
Como evitar:
- Higiene das mãos como medida mais eficaz e simples para a prevenção de infecções.
- Vacinação conforme o calendário.
- Diagnóstico correto e precoce
- Tratamento apropriado e oportuno
- Melhoria do saneamento básico e acesso à água potável de qualidade, como condição básica para a prevenção de infecções na população.
Tratamento:
- Ao apresentar qualquer um destes sintomas, procure avaliação médica para diagnóstico adequado e precoce da sepse.
- Profissionais de saúde devem buscar a fonte de infecção para iniciar o tratamento, que pode incluir antimicrobianos.
- A resistência aos antibióticos pode dificultar o tratamento.
Estratégia para contenção da sepse: Em 2024, foi lançada a Agenda Global para Sepse como a primeira estratégia global com ações e metas a ser alcançadas até 2030, apoiada por mais de 70 organizações e parceiros em todo o mundo.
A agenda é baseada em cinco pilares: O primeiro é a liderança política e a cooperação multilateral, com a meta de que 80% dos países de alta renda e 50% dos países de renda média e baixa adotem Planos Nacionais de Ação para a Sepse. O segundo pilar foca na preparação dos sistemas de saúde para oferecer atenção adequada à sepse e suas sequelas. Em terceiro lugar, destaca-se a importância da mobilização social, promovendo a conscientização sobre a doença entre o público geral, políticas, com campanhas consistentes e o envolvimento direto de sobreviventes e familiares de pacientes. O quarto pilar incentiva a pesquisa e a inovação para ampliar o conhecimento e o combate à sepse. Por fim, o quinto reforça a necessidade de incluir o manejo clínico da sepse no contexto de pandemias e outras emergências de saúde pública, garantindo uma resposta integrada e eficiente.
A estratégia é reduzir a incidência global em 25%; aumentar a taxa de sobrevida em 20% e reduzir o custo médio/paciente-sepse/país em 20%.
Foto: Divulgação
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