Ventilator-associated pneumonia agents in Brazilian Neonatal Intensive Care Units – a systematic review

Silva, André Ricardo Araújo da; Silva, Thais Carolina da; Bom, Gabriel José Teixeira; Vasconcelos, Raissa Maria Bastos; Simões, Robinson

doi:10.1016/j.bjid.2018.06.002

Cited by 12 publications

(12 citation statements)

References 14 publications

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“…The current study found a VAP rate of 5.7/1000 ventilator days in NICU, which is concomitant with neonatal VAP rate in the United States (4-6.5/1000 DD) and in other countries like Rio de Janiro and lower than the neonatal VAP rate in the International Health careassociated Infection Control Consortium (INICC) report which was 8.95/1000 DD and much lower than another Egyptian study which showed 34.2 episodes/1000 ventilator days. [17][18][19] This low rate observed in this study could be attributed to the routine strict implementation of VAP prevention bundle in CUSPH, NICU unit. 20 This study found that DAI mortality rate was 25%, this finding goes in harmony with Kasim et al, who studied nosocomial infections in NICUs, the authors found that mortality was significantly higher among infected neonates with VAP and CLABSI.…”

Section: Discussionmentioning

confidence: 61%

Device associated infections among neonates in neonatal intensive care units: a single unit survey study in Cairo, Egypt

Mohamed

Abdelfattah

et al. 2020

Int J Contemp Pediatr

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Background: Device Associated Infection (DAI) namely Ventilator Associated Pneumonia (VAP) and Central Line Associated Blood Stream Infection (CLABSI) is one of the challenges for both neonatal nurses and doctors. Aims of the study were 1) Assess the rate of DAI occurrence among neonates, 2) explore the relationship between DAI rates and certain risk factors such as nurse patient ratio, hand hygiene practice, gestational age (GA), weight, and length of hospital stay among neonates.Methods: Descriptive correlational survey research design. Sample: All neonates admitted in twelve months-duration were included (total number 1090 neonates). Nurses and doctors were observed for compliance to adequate hand hygiene technique. Tools: 1) Center for Disease Control (CDC) criteria to calculate DAI rates, 2) Hand hygiene five points checklist 3) Review of neonates charts to collect data as weight, GA 4) Ballard score and 5) nurse/patient ratio.Results: 24 neonates developed DAI, high significant negative correlations between DAI and infants’ weight, GA, nurse/patient ratio and overall compliance to hand hygiene techniques were reported (p-value ≤0.05). Length of hospital stay, inadequate hand hygiene technique had strong positive correlations with DAI rate (p-value ≤0.05).Conclusions: Factors that could affect DAI were infant’s weight, GA, length of hospital stay, inadequate hand hygiene technique and nurse/patient ratio. Recommendations: implementation of infection control programs to raise nurses as well as physicians’ compliance to adequate hand hygiene technique and increase number of nurses in the Neonatal Intensive Care Unit (NICU) per shift.

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Section: Discussionmentioning

confidence: 61%

Device associated infections among neonates in neonatal intensive care units: a single unit survey study in Cairo, Egypt

Mohamed

Abdelfattah

et al. 2020

Int J Contemp Pediatr

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“…Em países desenvolvidos como EUA e Canadá, a prevalência de pacientes internados com algum tipo de infecção contraída no ambiente hospitalar é próxima a 20% (Silva et al, 2018). Em um período de um ano, aproximadamente 100.000 pacientes terão algum tipo de infeção, seja de foco urinário, sanguíneo, ou mesmo advindo de ferida cirúrgica (Costa et al, 2017).…”

Section: Infecções Hospitalaresunclassified

“…O sítio de infecção notificada na maioria dos casos foi o trato respiratório (56,2%). Tais achados não são unânimes na literatura disponível, ocorrendo variações de acordo com o setor hospitalar analisado, o número de doentes da pesquisa e o tempo de análise (Dgs, 2015;Carvalho et al, 2017;Silva et al, 2018).…”

Section: Infecções Hospitalaresunclassified

Perfil microbiológico de pacientes internados no setor de terapia intensiva de hospital público da baixada maranhense

Batista

Nolêto

Sá

et al. 2022

RSD

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No setor da Unidade de Terapia Intensiva (UTI) cujo objetivo é estabilizar o paciente criticamente enfermo são realizados procedimentos invasivos que causam quebra de barreiras de proteção natural os quais associados ao perfil epidemiológico bem como o início empírico de antibióticos, favorece o desenvolvimento de bactérias multirresistentes, caracterizando assim, quadros graves com elevada morbidade e mortalidade. Dessa forma, a presente pesquisa teve como objetivo determinar o perfil microbiológico das culturas isoladas a partir de espécimes clínicos de pacientes internados na UTI adulta de um hospital público da Baixada maranhense, através da coleta dos resultados obtidos de exames de culturas microbianas. Trata- se de um estudo transversal, descritivo, retrospectivo, com dados laboratoriais do ano de 2018. Os dados foram tabulados e analisados em planilhas Excel®, analisados e descritos em frequências absolutas e percentuais para as variáveis categóricas e estatística descritiva da variável numérica. Dos resultados de 183 culturas, de bactérias e fungos, observou-se que 123 eram de pacientes do sexo masculino e 60 do feminino. A média de idade foi 56,69 anos (±21.89). A presença de microrganismos foi detectada em 139 hemoculturas, 29 culturas de secreção traqueal e 15 uroculturas. Quanto ao perfil aos antimicrobianos verificou-se que 30% dos microrganismos apresentaram sensibilidade à vancomicina, linezolida, gentamicina, teicoplamina, ciprofloxacina, meropenen e amicacina. Com relação aos perfis de resistência verificou-se maior resistência contra penicilina e ciprofloxacina. Estes achados reforçam a necessidade de esquemas antimicrobianos mais rígidos visando um maior controle do surgimento de bactérias multirresistentes.

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“…Terminologi ini merujuk kepada pneumonia yang terjadi pada setting ventilasi mekanik (Sebastian et al, 2012) yang mana muncul lebih dari 48 jam setelah intubasi endotracheal (ET) (Tablan et al, 2004). VAP merupakan salah satu infeksi nosocomial yang paling sering dialami oleh pasien (Lee et al, 2017;Silva et al, 2018) terutama bayi dengan berat badan rendah yang terpasang ventilator (Lee et al, 2017). VAP merupakan penyebab utama morbiditas dan mortalitas di ICU dan menyebabkan pemanjangan lenght of stay di rumah sakit dan ICU dan meningkatkan biaya rumah sakit (Alp & Voss, 2006).…”

Section: Pendahuluanunclassified

Pencegahan Kejadian Ventilator-Associated Pneumonia (VAP) dengan Kepatuhan Pelaksanaan Bundle: Literature Review

2020

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Prevention of Ventilator-Associated Pneumonia (VAP) Events with Compliance with Bundle Implementation: Literature Review Background: Patients who experience critical illness and use a mechanical ventilator in the ICU have an increased risk of experiencing ventilator associated pneumonia (VAP) which is a major cause of morbidity and mortality in the ICU and causes lengthening the length of stay and an increase in hospital costs.Purpose: To conduct a recent literature review with regard to VAP primarily related to causes, risk factors, pathogenesis, prevention, early detection and diagnosis, and administration of antibiotics to patients with VAP. At the end of this article conclusions will be presented that can be used by practitioners as a clinical guide.Method: The design used was literature review, articles were collected using a search engine, including (Clinicalkey) 27 articles, (Cochrane) 25 articles, (Medline) 17 articles and (Pubmed) 19 articles. From the predetermined article inclusion criteria, we found 7 articles out of 88 that were suitable for different interventionsResults: Prevention of VAP incidents in hospitals using multimodal interventions, one of which is the application of a VAP prevention bundle, can effectively reduce the incidence of VAP in hospitals. Examination of the lower respiratory tract culture should be carried out for all patients before administering antibiotic therapy provided that it should not delay giving antibiotic therapy to critical patients. Early treatment of broad-spectrum antibiotics with the right dosage can maximize the efficacy of antibiotics and the outcome of VAP patients in the ICU. Antibiotic combinations must be used wisely to treat VAP because certain pathogens increase the life expectancy of patients with severe infections especially those with septic shock. Negative culture results can also be used to stop antibiotic therapy in patients undergoing culture without antibiotic changes within the last 72 hours. The health team must consider the need for antibiotic de-escalation based on the culture results and the clinical response of the patient.Conclusion: VAP prevention bundles that implement multimodal interventions effectively reduce the incidence of VAP in hospitals. An examination of airway culture must be carried out for all patients before administering antibiotic therapy. Early treatment of broad-spectrum antibiotics can maximize the efficacy of antibiotics and the outcome of VAP patients in the ICU.Keywords: VAP; ICU; Patients; Morbidity; Mortality; BundlePendahuluan: Pasien yang mengalami penyakit kritis dan menggunakan ventilator mekanik di ICU mempunyai peningkatan resiko untuk mengalami ventilator associated pneumonia (VAP) yang merupakan penyebab utama morbiditas dan mortalitas di ICU serta menyebabkan pemanjangan lenght of stay dan peningkatan biaya rumah sakit.Tujuan: Untuk melakukan review literature terkini sehubungan dengan VAP terutama terkait dengan penyebab, faktor resiko, pathogenesis, pencegahan, deteksi dini dan diagnosis, serta pemberian antibiotik pada pasien dengan VAP. Di ahir artikel ini akan disampaikan kesimpulan yang dapat digunakan praktisi sebagai panduan di klinis.Metode: Desain yang digunakan adalah literature review, artikel dikumpulkan menggunakan mesin pencarian antara lain (Clinicalkey) 27 artikel, (Cochrane) 25 artikel, (Medline) 17 artikel dan (Pubmed) 19 artikel. Dari kriteria inklusi artikel yang telah ditentukan, ditemukan 7 artikel dari 88 yang sesuai dengan intervensi yang berbeda.Hasil: Pencegahan kejadian VAP di rumah sakit menggunakan intervensi multimodal, yang mana salah satunya berupa penerapan bundle pencegahan VAP, dapat dengan efektif menurunkan kejadian VAP di rumah sakit. Pemeriksasan kultur saluran nafas bawah perlu dilakukan kepada semua pasien sebelum pemberian terapi antibiotik dengan catatan tidak boleh menunda pemberian terapi antibiotik pada pasien kritis. Terapi dini antibiotik spektum luas dengan dosis yang tepat dapat memaksimalkan kemanjuran antibiotik dan luaran pasien VAP di ICU. Kombinasi antibiotik harus digunakan dengan bijaksana untuk mengobati VAP karena pathogen tertentu untuk meningkatkan harapan hidup pasien dengan infeksi berat terutama yang mengalami shok sepsis. Hasil kultur yang negatif juga dapat digunakan untuk menghentikan terapi antibiotik pada pasien yang dilakukan kultur tanpa perubahan antibiotik dalam 72 jam terahir. Tim kesehatan harus mempertimbangkan perlunya deeskalasi antibiotik berdasarkan hasil kultur dan respon klinik pasien.Simpulan: Bundle pencegahan VAP yang menerapkan intervensi multimodal efektif menurunkan kejadian VAP di rumah sakit. Pemeriksasan kultur saluran nafas harus dilakukan kepada semua pasien sebelum pemberian terapi antibiotik. Terapi dini antibiotik spektum luas dapat memaksimalkan kemanjuran antibiotik dan luaran pasien VAP di ICU.

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Ventilator-associated pneumonia agents in Brazilian Neonatal Intensive Care Units – a systematic review

Cited by 12 publications

References 14 publications

Device associated infections among neonates in neonatal intensive care units: a single unit survey study in Cairo, Egypt

Device associated infections among neonates in neonatal intensive care units: a single unit survey study in Cairo, Egypt

Perfil microbiológico de pacientes internados no setor de terapia intensiva de hospital público da baixada maranhense

Pencegahan Kejadian Ventilator-Associated Pneumonia (VAP) dengan Kepatuhan Pelaksanaan Bundle: Literature Review

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