A 10-year prospective surveillance of nosocomial infections in neonatal intensive care units

Couto, Renato Camargos; Carvalho, Elaine Alvarenga de Almeida; Pedrosa, Tânia Moreira Grillo; Pedroso, Ênio Roberto Pietra; Neto, Mozar C.; Biscione, Fernando Martín

doi:10.1016/j.ajic.2006.06.013

Cited by 152 publications

(135 citation statements)

References 26 publications

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“…As in most previous reports, BSI was the main cause of NI 3,8,9 . In this study, BSI occurred at a rate of 10.0 per 1,000 patient-days and accounted for 69.3% of all infections.…”

Section: Discussionmentioning

confidence: 52%

“…Birth weight has been advocated by the Centers for Disease Control and Prevention (CDC) as a variable for device-associated NI risk-stratified rate reporting in high-risk nurseries; however, this strategy has been rarely evaluated in neonates who are admitted to neonatal NICU in developing countries 3 .…”

Section: Introductionmentioning

confidence: 99%

“…Despite the recent advances in intensive medical care, while lifesaving, they expose critically ill patients to several infectious complications 2,3 .…”

Section: Introductionmentioning

confidence: 99%

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Nosocomial infections in a Brazilian neonatal intensive care unit: a 4-year surveillance study

Brito

Resende

et al. 2010

Rev. Soc. Bras. Med. Trop.

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Introduction: Report the incidence of nosocomial infections, causative microorganisms, risk factors associated with and antimicrobial susceptibility pattern in the NICU of the Uberlândia University Hospital. Methods‫׃‬ Data were collected through the National Healthcare Safety Network surveillance from January 2006 to December 2009. The patients were followed five times/week from their birth to their discharge or death. Results‫׃‬ The study included 1,443 patients, 209 of these developed NIs, totaling 293 NI episodes, principally bloodstream infections (203; 69.3%) and conjunctivitis (52; 17.7%). Device-associated infection rates were as follows: 17.3 primary bloodstream infections per 1,000 central line-days and 3.2 pneumonias per 1000 ventilator-days. The mortality rate in neonates with NI was 11.9%. Mechanical ventilation, total parenteral nutrition, orogastric tube, previous antibiotic therapy, use of CVC and birth weight of 751-1,000g appeared to be associated with a significantly higher risk of NI (p ≤ 0.05). In multiple logistic regression analysis for NI, mechanical ventilation and the use of CVC were independent risk factors (p ≤ 0.05). Coagulase-negative Staphylococcus (CoNS) (36.5%) and Staphylococcus aureus (23.6%) were the most common etiologic agents isolated from cultures. The incidences of oxacillin-resistant CoNS and S. aureus were 81.8% and 25.3%, respectively. Conclusions‫׃‬ Frequent surveillance was very important to evaluate the association of these well-known risk factors with NIs and causative organisms, assisting in drawing the attention of health care professionals to this potent cause of morbidity.

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“…As in most previous reports, BSI was the main cause of NI 3,8,9 . In this study, BSI occurred at a rate of 10.0 per 1,000 patient-days and accounted for 69.3% of all infections.…”

Section: Discussionmentioning

confidence: 52%

Section: Introductionmentioning

confidence: 99%

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Nosocomial infections in a Brazilian neonatal intensive care unit: a 4-year surveillance study

Brito

Resende

et al. 2010

Rev. Soc. Bras. Med. Trop.

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“…Very limited information is available from developing countries on infection rates per hospital-days or device-days including Brazilian units 5 . Incidence density rates per healthcare-associated infection in few studies [6][7] were higher than those observed in most studies in the United States or Europe 8 .…”

Section: Reduction Of Catheter-associated Bloodstream Infections Thromentioning

confidence: 99%

“…Other studies have shown previously that CNSes were the most frequent agents of BSI as in our NICU 7 . In contrast, Gram-negative bacilli, mainly Klebsiella spp., Escherichia coli, and Enterobacter spp., were most frequent in developing countries [5][6] .…”

Section: Conflict Of Interest Referencesmentioning

confidence: 99%

Reduction of catheter-associated bloodstream infections through procedures in newborn babies admitted in a university hospital intensive care unit in Brazil

Resende

Brito

et al. 2011

Rev. Soc. Bras. Med. Trop.

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INTRODUCTION: Catheter-associated bloodstream infection (CA-BSI) is the most common nosocomial infection in neonatal intensive care units. There is evidence that care bundles to reduce CA-BSI are effective in the adult literature. The aim of this study was to reduce CA-BSI in a Brazilian neonatal intensive care unit by means of a care bundle including few strategies or procedures of prevention and control of these infections. METHODS: An intervention designed to reduce CA-BSI with five evidence-based procedures was conducted. RESULTS: A total of sixty-seven (26.7%) CA-BSIs were observed. There were 46 (32%) episodes of culture-proven sepsis in group preintervention (24.1 per 1,000 catheter days [CVC days]). Neonates in the group after implementation of the intervention had 21 (19.6%) episodes of CA-BSI (14.9 per 1,000 CVC days). The incidence of CA-BSI decreased significantly after the intervention from the group preintervention and postintervention (32% to 19.6%, 24.1 per 1,000 CVC days to 14.9 per 1,000 CVC days, p=0.04). In the multiple logistic regression analysis, the use of more than 3 antibiotics and length of stay >8 days were independent risk factors for BSI. CONCLUSIONS: A stepwise introduction of evidence-based intervention and intensive and continuous education of all healthcare workers are effective in reducing CA-BSI.

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A potential antimicrobial treatment against ESBL-producing Klebsiella pneumoniae using the tellurium compound AS101

et al. 2009

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Due to the extensive spread of antibiotic-resistant Klebsiella pneumoniae, the non-toxic immunomodulator, ammonium trichloro (dioxoethylene-o, o') tellurate (AS101), was introduced for the first time in this study. Eleven strains of K. pneumoniae were tested: five were extended spectrum beta lactamase (ESBL)-producing strains and six were non-ESBL-producing strains. The MIC and MBC of ten strains were 9 microg/ml AS101 and 18 microg/ml for one strain. AS101 treatment inhibited bacterial growth in a dose-dependent manner on protein-rich media. No inhibition by AS101 was observed on poorer media. In combination with beta-mercaptoethanol (2-ME) or cysteamine, AS101 inhibited bacterial growth in both types of media. Growth inhibition was also shown following AS101 treatment at both lag and log phases. Our data indicate that AS101 enters the bacterium through its porins, causing bacterial destruction. The mechanism of cell death was characterized using several techniques: (a) scanning electron microscopy showed that bacteria treated with AS101 or in combination with cysteamine exhibited evidence of cell-wall damage; (b) X-ray microanalysis demonstrated damage to Na/K pumps; and (c) transmission electron microscopy demonstrated cell lysis. These phenomena suggest that AS101 has antibacterial potential against K. pneumoniae infections.

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A 10-year prospective surveillance of nosocomial infections in neonatal intensive care units

Cited by 152 publications

References 26 publications

Nosocomial infections in a Brazilian neonatal intensive care unit: a 4-year surveillance study

Nosocomial infections in a Brazilian neonatal intensive care unit: a 4-year surveillance study

Reduction of catheter-associated bloodstream infections through procedures in newborn babies admitted in a university hospital intensive care unit in Brazil

A potential antimicrobial treatment against ESBL-producing Klebsiella pneumoniae using the tellurium compound AS101

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