Infections in Patients Psychiatric: the Importance of Diagnosis, Classification, Treatment and Prevention

Background: The identification of the presence of infections in patients psychiatric is not always carried out in a systematic way; it has been little studied and publicized up to the present days, in spite of the fact that these patients, as well as any other citizens, are subject to physical sickness and to the occurrence of clinical comorbidities, and, among them, the infections.

Objective: To identify the presence of infections with comorbidities in patients psychiatric, to utilize the data built to guide classification, treatment and to help build specific prevention practices.

Methods: A descriptive study of infections identified in psychiatric inpatients in public hospital in the period ranging from 1999 to 2006.

Results: In the assessed period, 3,234 infections were identified, 57.14% of them having their origin in the community and 42.86% in hospitals. The maximum registered rate of nosocomial infections was 5.55 and the minimum 1.53 per 1,000 patients-day. Including the manifestations of hospital pediculosis and scabies, the calculated rates range from 1.83 to 8.83 per 1,000 patients-day. The main sites affected were the skin and soft-tissue, the eyes, the ears, the nose and mouth and the respiratory tract. Not occurred any outbreaks. The principal antimicrobial utilized was amoxicillin.

Conclusions: The clinical practice, as it evaluated in an extended way the psychiatric inpatients, allowed for the diagnosis of a high number of infections communitary and nosocomial, with undeniable benefits for those patients that are not routinely cared for in public Health Service Centers, either due to difficulty in spontaneous requests for service, fragility in the information about their clinical members or even the lack of qualification of local professionals to care for mentally ill patients. The identification of the main sites affected by infections and infestations that were diagnosed helped to build specific preventive practices such as hygienization routines, wound treatment and the adoption of weekly re-evaluation of the head and skin, aiming at an early detection approach to pediculosis and scabies. The  main treatment of infectious diseases was less aggressive and more cost-effective.