Health care-associated infections in critically ill premature newborns: epidemiology, clinical features and diagnostics in modern conditions

Nikitina, I. V.; Gerasimova, Anastasiya V.; Ivanova, Lyubov A.; Krogh-Jensen, O.A.; Isaeva, E.L.; Lenyushkina, A.A.; Priputnevich, Т.В.; Degtyarev, D.N.

doi:10.33029/2308-2402-2020-8-3-7-17

Neonatology: News, Opinions, Training

2020

DOI: 10.33029/2308-2402-2020-8-3-7-17

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Health care-associated infections in critically ill premature newborns: epidemiology, clinical features and diagnostics in modern conditions

I. V. Nikitina¹,

Anastasiya V. Gerasimova²,

Lyubov A. Ivanova³

et al.

Abstract: Журнал для непрерывного медицинского образования врачей ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ ставителей условно-патогенных микроорганизмов, выделенных из зева и ануса, у недоношенных детей любого гестационного возраста превалировали грамположительные коагулазонегативные стафилококки, чаще всего -Staphylococcus epidermidis. Грамотрицательная флора была представлена различными видами семейства Enterobacteriaceae с преобладанием Klebsiella pneumoniae во всех группах детей. Выделение грибковой микрофлоры отмечалось лишь у гл… Show more

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Cited by 5 publications

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Expression of CD14+CD282+, CD14+CD284+, CD14+HLA-DR+, CD14+CD11b+ receptors and sIgA level in premature infants with K. pneumoniae

Chistyakova,

Remizova,

Ustyuzhanin

et al. 2024

Med. immunol.

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K. pneumoniae is one of the leading microorganisms causing nosocomial infections among premature newborns. The ineffectiveness of immune defense, morphofunctional immaturity, length of hospitalization and invasive procedures create the prerequisites for the implementation of the infectious process in a hospital setting. The question of the reasons for the development of infection, the etiological agent of which colonizes the intestines, remains open. Purpose of the study: to evaluate the expression of CD14+CD282+, CD14+CD284+, CD14+HLA-DR+, and CD14+CD11b+ receptors on blood monocytes and the level of sIgA in coprofiltrates in premature infants with intestinal colonization by K. pneumonia with different genetic profiles. We examined 11 children with the uge gene (group 1), 20 newborns with the uge + fim genes (group 2), and 12 children with the kfu + uge + fim genes. Microbiological examination of feces included identification and antibiotic sensitivity of microorganisms. Detection of the uge, fim and kfu genes in K. pneumoniae strains was carried out by PCR. The expression level of monocyte activation markers was determined by flow cytometry. Gestational age and anthropometric parameters did not differ between newborns. Children identified with the fim gene in combination with other genes were more often discharged home with K. pneumoniae than with the uge gene. In these children, a decrease in the level of expression of CD14+CD282+, CD14+CD284+, CD14+CD11b+, CD14+HLA-DR+ receptors at birth and upon reaching postconceptional age, and a low sIgA content in coprofiltrates during 24 days of life were recorded. Thus, a decrease in the expression of CD14+CD282+, CD14+CD284+, CD14+CD282+ and CD14+HLA-DR+ receptors by blood monocytes and insufficiency of sIgA production in the large intestine determine a long period of colonization of K. pneumoniae strains with the presence of the fim gene in combination with other genes (from 15 to 180 days), as well as the possibility of Klebsiella infection occurring in subsequent periods of the child’s life. Much more often, children with the combination of genes uge + fim and kfu + uge + fim were discharged from the hospital with a diagnosis of anemia; only in these groups of children was the development of bronchopulmonary dysplasia recorded.

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Expression of CD14+CD282+, CD14+CD284+, CD14+HLA-DR+, CD14+CD11b+ receptors and sIgA level in premature infants with K. pneumoniae

Chistyakova,

Remizova,

Ustyuzhanin

et al. 2024

Med. immunol.

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Diagnosis of early neonatal infections in premature newborns

Ivanov,

Aleksandrovich,

Pavlovskaya

et al. 2024

Rus. J. Anes. Reanim.

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Features of Microbiota in Newborns in Critical Condition at Admission to the Intensive Care Unit of a Specialized Hospital

Aleksandrovich

Ivanov

Pavlovskaya

et al. 2022

Vestn. anesteziol. reanimatol.

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Clarification of etiology and identification of infectious agents in critically ill newborns is a very urgent problem of neonatal resuscitation.The objective. To study the characteristics of microbiota in critically ill newborns at admission to the intensive care unit (ICU) of a specialized hospital.Subjects and Methods. 165 critically ill newborns were examined, and bacteriological tests of blood, feces, and saliva were performed.Results. Positive culture results were obtained in 40 (24%) patients. The most frequent causative agent was S. epidermidis (47.5%). The detection rate of E. faecalis amounted to 15%, S. haemolyticus ‒ 15%, C. albicans – 12.5%, and K. pneumoniae ‒ 10%. Microorganisms were isolated from feces in 70% of cases, from the oral cavity in 62.5%, and from blood in 12.5%. E. faecalis was equally frequent at all three sites (5%).Conclusion. In 76% of patients, no neonatal infectious agent was isolated at admission to ICU of a specialized hospital that is most likely associated with the early administration of antibacterial drugs in the first hours of life of the newborn.

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Health care-associated infections in critically ill premature newborns: epidemiology, clinical features and diagnostics in modern conditions

Cited by 5 publications

References 1 publication

Expression of CD14+CD282+, CD14+CD284+, CD14+HLA-DR+, CD14+CD11b+ receptors and sIgA level in premature infants with K. pneumoniae

Expression of CD14+CD282+, CD14+CD284+, CD14+HLA-DR+, CD14+CD11b+ receptors and sIgA level in premature infants with K. pneumoniae

Diagnosis of early neonatal infections in premature newborns

Features of Microbiota in Newborns in Critical Condition at Admission to the Intensive Care Unit of a Specialized Hospital

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