Study of multi-drug resistant microorganisms isolated from blood cultures of hospitalized newborns in Rio de Janeiro city, Brazil

Loureiro, Marcio Martins; Moraes, Bianca Aguiar de; Quadra, M. R. R.; Pinheiro, G. S.; Asensi, Marise Dutra

doi:10.1590/s1517-83822002000100015

Cited by 16 publications

(18 citation statements)

References 26 publications

(50 reference statements)

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“…A recent study made in Rio de Janeiro by Loureiro et al [27] found 5.6% infection, which was similar to our results. On the other hand, Tapia-Rombo et al [2] observed 23.8% infection in Mexico.…”

Section: Discussionsupporting

confidence: 93%

Infection and colonization by Staphylococcus aureus in a high risk nursery of a Brazilian teaching hospital

et al. 2003

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Neonates are susceptible to nosocomial infections due to immunological immaturity, prolonged hospital stay and the use of invasive procedures. We evaluated the incidence of infections and the prevalence of colonization by MRSA (Methicillin-resistant Staphylococcus aureus) and MSSA (Methilin-susceptible Staphylococcus aureus), as well as colonization risk factors. Staphylococcal infections were observed by analyzing medical records in the HICS (Hospital Infection Control Service) and the HRN (High Risk Nursery). Additionally, four inquiries concerning colonization prevalence were made for S. aureus, from January/2000 to December/2002. Clinical specimens from the nostrils, mouth and anus were cultivated in mannitol-salt agar plates and identification was made through standard methods. The frequency of neonates colonized by S. aureus was 49%. MSSA was more prevalent (57%) than MRSA (43%). Risk factors related to the acquisition of MRSA were: low weight and antibiotic use. , Hospital stay was the only variable significantly associated with colonization by S. aureus. The incidence of infections by S. aureus during the last three years was 2.18% (159 cases). Nine of them (5.5%) were associated with MRSA and 150 (94.5%) with MSSA. Staphylococcal infections were considered as invasive (sepsis) and noninvasive (conjunctivitis, cutaneous), corresponding to 31% and 69%, respectively. The MRSA phenotype in infection was rare compared with methicillin-susceptible samples, although S. aureus, MRSA and MSSA colonization rates were high.

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Section: Discussionsupporting

confidence: 93%

Infection and colonization by Staphylococcus aureus in a high risk nursery of a Brazilian teaching hospital

et al. 2003

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“…Risk factors for colonization/ infection by GNB in neonates included antibiotic therapy (14,21). Exposure to antibiotic therapy is usually high in NICU population, highest in Brazil as observed in this study (52.0%) and others recent reports by Nagata et al (46.0%) (14) and Loureiro et al (83.0%) (11) in Londrina and Rio de Janeiro, respectively. Colonization with resistant GNB was related to empiric use of antibiotics in several studies (1,17).…”

Section: Discussionsupporting

confidence: 65%

“…Very low birth weight has been recognized as a factor that predicts neonatal mortality with good discrimination (1,18). In other Brazilian studies (11,14) birth weight, prematurity, low gestational age, mechanical ventilation, total parenteral nutrition, vascular/umbilical catheter, intubation in the delivery room and the use of antibiotics were considered as risk factors associated with nosocomial infections in NICU.…”

Section: Discussionmentioning

confidence: 99%

Infection and colonization by Gram-negative bacilli in neonates hospitalized in High Risk Nursery at Uberlandia Federal University Hospital: etiology, resistant phenotypes and risk factors

Cezário¹,

Ribas²,

Abdallah³

et al. 2004

Braz. J. Microbiol.

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The aims of this study were to determine endemic and epidemic infection due to Gram-negative bacilli, risk factors associated with colonization and infection by these organisms and the resistance phenotypes (ESBL, AmpC) in neonates admitted in a High Risk Nursery. The study was conducted during a 21 month period and included: a prospective study to evaluate the neonates with hospital infection and the use of third-generation cephalosporins; a case-control study to determine the risk factors associated with colonization/infection. Rectal and oropharynx cultures were also performed in four opportunities (September and November 2001, February and August 2002). The isolates for which the resistance of ceftazidime was 2 µg/mL were suspected of producing ESBL or AmpC β-lactamases. The incidence of infection by Gram-negative bacilli was 2.4% (89/ 3.708 neonates), and sepsis (35.9%) and conjunctivitis (31.4%) were the most common infections. The endemic infections were more prevalent (73.9%) and usually associated with Enterobacteriaceae (95.5%), being these organisms also related to colonization, corresponding mainly to isolates of Enterobacter spp. and Klebsiella spp. Two outbreaks of Pseudomonas aeruginosa (n=10) and Acinetobacter baumannii (n=11) were identified during the survey. Univariate analysis showed that risk factors for Gram-negative bacilli infection considered significant included: the length of stay before infection/colonization, exposure to antimicrobial agents, mechanical ventilation, central venous catheters, parenteral nutrition and surgery. The majority of resistance to ceftazidime among Enterobacteriaceae isolates (80.9%) was from ESBL phenotype. Administration of thirdgeneration cephalosporins (ceftriaxone) led to the emergence of these multiresistant Gram-negative bacilli in the neonatal unit.

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“…This may be due to emergence of resistant strains as a result of indiscriminate use of antibiotics. The high resistance rates found in this study may be associated with the frequent use of antimicrobial drugs for both prophylactic and therapeutic treatment of hospitalized newborns 32 . In view of the above facts the strategy of antibiotic usage in neonates should be reviewed periodically even in the same hospital…”

Section: Discussionmentioning

confidence: 72%

Study of Bacteriological pathogen causing neonatal sepsis at NICU in Ad-din medical college hospital

Begum

Hassan

Haque

et al. 2015

Northern Int. Med. Coll. J.

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Objective : To determine the common causative bacterial agents of neonatal sepsis and their antimicrobial susceptibility in NICU Methods : Newborns with clinical signs of septicemia and positive blood culture during twelve months were prospectively studied. Samples for blood cultures, complete blood count, C-reactive protein, sugar, electrolytes were obtained ; ampicillin and gentamycin were started empirically.Result : Seven hundred and three neonates were investigated to rule out of sepsis. The male, female ratio was 1.3:1 and 56(63.63%) of patients were preterm and 32(36.36%) were term neonates. There were 68 (77.27%) cases of Early onset neonatal sepsis (EONS) and 20(22.64%) of Late onset neonatal sepsis (LONS). Coagulase negative staphylococcus (CONS) was the most common 37(42.04%) Gm+ve pathogen causing early onset neonatal sepsis and Acinetobacter was common Gm-ve pathogen in both early onset 16(18%) and late-onset 8 (9%) sepsis. CONS sepsis showed high degree of resistance to commonly used antibiotics; ampicillin (86.5%), oxacillin (60%),cefotaxime (67%) but comparatively low resistance to vancomycin (0%), gentamicin (25%), Levofloxacin(36%) & Imipenem (49%). Acinetobacter were highly resistant to ampicillin (100), gentamicin(75%), cefotaxime(100) and sensitive to Amikacin (58.33%), ciprofloxacin (54.16%), Levofloxacin a n d Imipenem (62.5%)and Colistin (95.83%). Conclusion :Neonatal sepsis in our NICU is mainly caused by grampositive organisms, which are developing resistance to commonly used antibiotics. The initial empirical choice of Ampicillin and Gentamicin appears to be unreasonable for our environment.

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Study of multi-drug resistant microorganisms isolated from blood cultures of hospitalized newborns in Rio de Janeiro city, Brazil

Cited by 16 publications

References 26 publications

Infection and colonization by Staphylococcus aureus in a high risk nursery of a Brazilian teaching hospital

Infection and colonization by Staphylococcus aureus in a high risk nursery of a Brazilian teaching hospital

Infection and colonization by Gram-negative bacilli in neonates hospitalized in High Risk Nursery at Uberlandia Federal University Hospital: etiology, resistant phenotypes and risk factors

Study of Bacteriological pathogen causing neonatal sepsis at NICU in Ad-din medical college hospital

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