Surveillance of pediatric infections in a teaching hospital in Mato Grosso do Sul, Brazil

Abstract

Nosocomial infections (NI) result in considerably high mortality and morbidity rates, especially among pediatric patients. Considering current worldwide changes, information about the occurrence of pathogens and susceptibility tests are now seen as decisive for optimizing treatment. The purpose of this research was to determine the frequency of microorganisms, antimicrobial and genetic profiles, and risk factors associated with nosocomial infections in a teaching hospital in Campo Grande, Mato Grosso do Sul. From January 1998 to December 1999, 108 patients were characterized as having nosocomial infection, from which 137 pathogens were isolated. Identification and antimicrobial susceptibility was determined by conventional and automated techniques. Staphylococcus aureus and Klebsiella pneumoniae strains were characterized by Pulsed Field Gel Electrophoresis (PFGE). Pathogens were most often isolated from infants one-month old or younger, and bloodstream infections were the most frequent. The main isolated agents isolated were: coagulase-negative staphylococci (38), Pseudomonas aeruginosa (19), S. aureus (26), K. pneumoniae (18), and Candida spp. (13). The risk conditions that were most closely related to NI acquisition were: prolonged hospital stays (69.4%), prematurity (60.9%) and exposure to high-risk device procedures (95.4%). Ciprofloxacin and imipenem were the most effective drugs, inhibiting all or almost all of the Enterobacteriaceae, P. aeruginosa and Acinetobacter calcoaceticus isolates. Only 23% of the S. aureus samples were resistant to oxacillin. Genomic typing revealed 10 distinct patterns for S. aureus and 13 for K. pneumoniae, suggesting that most them did not belong to the same clone. PFGE was effective in differentiating the strains.

Candida spp. isolated from inpatients, the environment, and health practitioners in the pediatric unit at the Universitary Hospital of the Jundiaí Medical College, state of São Paulo, Brazil

“…The hospital sector where cases of candidemia are most commonly found is the ICU, for besides being the place where patients find themselves more impaired, it also completes a routine of invasive procedures, probes, and long-term catheters 19,[27][28][29] . All the candidemia cases in this study were observed in patients in ICUs, a point that is also discussed by other studies that recognize the ICU as a place of utmost susceptibility to the incidence of such infection [30][31][32][33] . The absolute mortality rate due to candidemia was 23.1%, a result that is also consonant with the data provided by the bibliographic references [18][19][20] .…”

Risk factors for nosocomial bloodstream infection caused by multidrug resistant gram-negative bacilli in pediatrics

“…Currently, Gram-negative bacteria are still among the most important agents involved in pediatric bloodstream infections, responsible for approximately 24% to 50% of the cases [5,6,8,9,14]. We have also observed that the frequency of these agents presents variations according to region or medical service studied.…”

Antimicrobial Susceptibility Pattern and ESBL Production among Uropathogenic Escherichia coli Isolated from UTI Children in Pediatric Unit of a Hospital in Kerman, Iran

“…Similarly, the amoxicillin + clavulanic acid (30μg/10μg) disk was placed 20mm apart. After incubating overnight at 37°C for 24 hours, a ≥ 5mm or more increase in the zone diameter around cefotaxime/clavulanic acid (CTX/Clav) was considered positive for ESBL production [11]. E.coli ATCC25922 was used as negative ESBL control.…”