Healthcare associated infections caused by coagulase-negative<i>Staphylococci</i>in a neonatal intensive care unit

Silva, André Ricardo Araújo da; Simões, Maria Luiza Costa de Lima; Werneck, Lúcia dos Santos; Teixeira, Cristiane Henriques

doi:10.5935/0103-507x.20130041

Cited by 8 publications

(6 citation statements)

References 25 publications

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“…Of a total of 5596 citations identified, 138 met the criteria for abstract review and 52 met the criteria for full-text assessment, of which 15 met the inclusion criteria for this review, namely, Kawagoe, JY et al 2001 [ 16 ]; Nagata, E et al 2002 [ 17 ]; Pessoa-Silva, CL et al 2004 [ 18 ]; Couto, RC et al 2007 [ 19 ]; Távora, AC et al 2008 [ 20 ]; Pereira, SM et al 2009 [ 21 ]; Catarino, CF et al 2012 [ 22 ]; Dal-Bó, K et al 2012 [ 23 ]; Freitas, BA et al 2012 [ 24 ]; Ventura, CM et al 2012 [ 25 ]; Romanelli, RM et al 2013 [ 26 ]; da Silva, AR et al 2013 [ 27 ]; de Souza Rugolo, LM et al 2014 [ 28 ]; Urzedo, JE et al 2014 [ 29 ]; Freitas, FTM et al 2019 [ 30 ] (Fig. 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies (80.0%) included all infants admitted to the NICU, two (13.3%) included only infants < 1500 g, and one (6.7%) included only preterm infants. According to the definition of HAI, seven (46.7%) studies reported the use of the American Centers for Disease Control and Prevention (CDC) [ 27 ], four (26.6%) reported the use of the Brazilian Sanitary Agency (ANVISA) [ 28 ], two (13.3%) did not report which definition they used, one (6.7%) reported the use of both CDC and ANVISA definitions, and one (6.7%) developed its own definition. Table 1 shows a summary of the characteristics of the assessed studies.…”

Section: Resultsmentioning

confidence: 99%

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Neonatal healthcare-associated infections in Brazil: systematic review and meta-analysis

Freitas

Viegas²,

Romero

2021

Arch Public Health

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Background Healthcare-associated infections (HAI) are important causes of neonatal morbidity and mortality in developing countries. We reviewed the incidence and the pathogens involved in HAI among infants admitted to neonatal intensive care units (NICU) in Brazil. Methods A search was conducted in the MEDLINE, LILACS and SciELO databases from January 1995 to October 2019. Two authors scrutinized potential articles independently, after one author selected them from screening abstracts from every article flagged as related to neonatal HAI. Then, they were included in the review if they met our inclusion criteria. The studies were evaluated based on a quality score proposed by the authors, rated 0 to 1, with 1 point as the best quality rate. Pooled estimates and 95% confidence intervals (95% CI) for HAI cumulative incidence and incidence density were calculated, when the same denominators were available, using meta-analysis. A quality effect was applied to the models using the MetaXL software. Heterogeneity was assessed using I2 statistics and the Cochran’s Q test. Results Of a total of 5596 citations identified, 15 studies met the inclusion criteria for this review, which comprised 24,408 patients and 312,744 patient-days. Quality of the studies varied between 0.36 and 1 according to the adopted score, and six (40.0%) studies presented a score of 1. Pooled HAI incidence was 36.1 (95% CI 22.8–50.7) infections and 26.3 (95% CI 18.4–35.0) infected patients per 100 patients. Pooled HAI incidence density was 23.5 (95% CI 16.3–33.9) per 1000 patient-days. Pooled incidence density rates of bloodstream infection and ventilator-associated pneumonia were 13.1 per 1000 catheter-days (95% CI 4.3–40.1) and 7.9 per 1000 ventilator-days (95% CI 1.1–55.5), respectively. A high degree of heterogeneity was observed in all models (I2 > 98% and Cochran’s Q test with p < 0.05). Coagulase-negative Staphylococci (32.1%), Staphylococcus aureus (13.8%) and Klebsiella spp. (12.4%) were the most prevalent causative bacterial pathogens. Conclusions The findings show high incidence of neonatal HAI in Brazilian NICU; therefore, efforts to standardize the collection and notification of HAI are needed in order to strengthen surveillance in the country and implement preventive measures, routine assessment, and close monitoring of neonates.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Neonatal healthcare-associated infections in Brazil: systematic review and meta-analysis

Freitas

Viegas²,

Romero

2021

Arch Public Health

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“…Studies from some European countries [ 23 ] and Brazil [ 24 ] have documented the contributions of CoNS in neonatal sepsis, which could result in increased risk of mortality and morbidities., There are limited data on the incidence of CoNS in neonatal sepsis in Kuwait [ 25 , 26 ]. However, there are no studies on the molecular characteristics of CoNS associated with neonatal sepsis in Kuwait.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial resistance and virulence determinants in coagulase-negative staphylococci isolated mainly from preterm neonates

Al-Haqan¹,

Boswihi²,

Pathan³

et al. 2020

PLoS ONE

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Coagulase-negative staphylococci (CoNS) are the most common isolates from blood culture in neonates resulting in high mortality and morbidity. This study investigated CoNS obtained from blood cultures of neonates for antibiotic resistance and virulence factors, and possible association with inflammatory response (C-reactive protein). A total of 93 CoNS isolates were collected from 76 blood cultures of neonates at the Maternity hospital in Kuwait in a six-month period and investigated for susceptibility to antibiotics, carriage of staphylococcal cassette chromosome mec (SCC mec ), and virulence-associated genes. The 93 CoNS isolates consisted of S . epidermidis (76; 81.7%), S . capitis (12; 12.9%), S . hominis (2; 2.1%), S . warneri (2; 2.1%) and S . haemolyticus (1; 1.0%). Eighty-six (92.4%) of the isolates were resistant to cefoxitin (MR-CoNS) while 49 (52.7%) expressed multi-antibiotic resistance. The methicillin-resistant isolates (MR-CoNS) carried SCC mec III, SCC mec IVa and four combinations of SCC mec types including SCC mec types I+IVa (one S . warneri and 25 S . epidermidis isolates), types I+III (one S . epidermidis isolate), types III+IVa (six S . epidermidis isolates) and types I+III+IVa (one S . epidermidis isolate). The most common virulence-related genes were icaC , seb , arc detected in 69.7%, 60.5%, 40.8% of the isolates respectively. Two isolates were positive for tst1 . No association between C-reactive protein and antibiotic resistance or virulence factors was established. This study revealed that S . epidermidis carrying different SCC mec genetic elements, was the dominant CoNS species isolated from neonatal blood cultures with 90.3% and 36.6% of the isolates positive for genes for biofilm and ACME production respectively.

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“…In addition, CoNS are usually saprophytic bacteria in a patient's microbiota; thus, they do not have a high antibiotic resistance that explains the minor differences observed in the MAR between the wards. The lower MAR of SA in the medical wards compared with the ICU can be explained by the lower exposure to antibiotics, and the low MAR of CoNS in the paediatric wards is easily explained by the overall low exposure time of children to antibiotics, due to the low age ( 21 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial resistance in bacterial pathogens among hospitalised patients with severe invasive infections

Zlatian

Bălăşoiu

et al. 2018

Exp Ther Med

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The most severe infections are invasive infections, due to the fact that the germs can accumulate in multiple sites and produce a body-wide infection known as sepsis. Septic shock has the highest mortality rate among non-traumatic medical conditions. In this study, we aimed to evaluate the incidence and prevalence of invasive infections in a hospital environment. Another second objective was to establish the aetiology of invasive infections in our hospital and the antibiotic resistance profile of the germs involved, which are both important for determining the therapeutic approach for the treatment of these infections. The study included 505 hospitalized patients from which we collected a total of 974 blood cultures. For the analysis of the blood cultures, we used an automated incubator. The bottles flagged as positive were subcultured on blood agar, and the grown colonies were identified using an identification system. Invasive infections had a prevalence rate of 27.72% in our hospital. From the 974 blood cultures, we isolated 170 bacterial strains: Staphylococcus aureus (SA; 63 strains, 37.06%), Klebsiella spp. (27 strains, 15.88%), coagulase-negative staphylococci (CoNS; 18 strains, 10.59%), Enterococcus spp. (17 strains, 10.00%), Escherichia coli (12 strains, 7.06%), Streptococcus spp. (11 strains, 6.47%) and other bacterial species. The prevalence of methicillin-resistant SA (MRSA) in our study was 36.51% from the SA strains. The MRSA prevalence differed significantly according to age (37.50% in adults vs. 28.57% in children, P=0.047) and ICU admission (42.42% in ICU patients vs. 30.00% in non-ICU patients, P=0.018). We performed a multivariate analysis of the invasive infection risk which detected as significant predictors the admission into the cardiology ward and plastic surgery ward. On the whole, the findings of this study indicate that the high prevalence of Gram-positive cocci in blood cultures, mostly SA, with multidrug resistance has important consequences for the management of invasive infections.

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Healthcare associated infections caused by coagulase-negativeStaphylococciin a neonatal intensive care unit

Cited by 8 publications

References 25 publications

Neonatal healthcare-associated infections in Brazil: systematic review and meta-analysis

Neonatal healthcare-associated infections in Brazil: systematic review and meta-analysis

Antimicrobial resistance and virulence determinants in coagulase-negative staphylococci isolated mainly from preterm neonates

Antimicrobial resistance in bacterial pathogens among hospitalised patients with severe invasive infections

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