Nosocomial Bloodstream Infections in Brazilian Pediatric Patients: Microbiology, Epidemiology, and Clinical Features

Abstract

BackgroundNosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality and are the most frequent type of nosocomial infection in pediatric patients.MethodsWe identified the predominant pathogens and antimicrobial susceptibilities of nosocomial bloodstream isolates in pediatric patients (≤16 years of age) in the Brazilian Prospective Surveillance for nBSIs at 16 hospitals from 12 June 2007 to 31 March 2010 (Br SCOPE project).ResultsIn our study a total of 2,563 cases of nBSI were reported by hospitals participating in the Br SCOPE project. Among these, 342 clinically significant episodes of BSI were identified in pediatric patients (≤16 years of age). Ninety-six percent of BSIs were monomicrobial. Gram-negative organisms caused 49.0% of these BSIs, Gram-positive organisms caused 42.6%, and fungi caused 8.4%. The most common pathogens were Coagulase-negative staphylococci (CoNS) (21.3%), Klebsiella spp. (15.7%), Staphylococcus aureus (10.6%), and Acinetobacter spp. (9.2%). The crude mortality was 21.6% (74 of 342). Forty-five percent of nBSIs occurred in a pediatric or neonatal intensive-care unit (ICU). The most frequent underlying conditions were malignancy, in 95 patients (27.8%). Among the potential factors predisposing patients to BSI, central venous catheters were the most frequent (66.4%). Methicillin resistance was detected in 37 S. aureus isolates (27.1%). Of the Klebsiella spp. isolates, 43.2% were resistant to ceftriaxone. Of the Acinetobacter spp. and Pseudomonas aeruginosa isolates, 42.9% and 21.4%, respectively, were resistant to imipenem.ConclusionsIn our multicenter study, we found a high mortality and a large proportion of gram-negative bacilli with elevated levels of resistance in pediatric patients.

Detection of High Prevalence of TEM/SHV/CTX-M Genes in ESBL Producing and Multidrug Resistant Klebsiella Pneumoniae and Klebsiella Oxytoca

“…The presence of TEM, SHV and CTX-M genes alone in the study of Alibi et al in Tunisia was high compared to our results with 3.39% (4/118), 4.23% (5/118) and 11% (13/118) respectively [54]. In Mozambique, on 19 [57]. It is observed that the expression of bla CTX-M is currently more prevalent and as we report for the first time in Togo, more frequent in a triple combination with bla TEM and bla SHV .…”

Contaminação de torniquetes para punção intravenosa periférica

“…In recent years, however, they have been related to important nosocomial infections, mainly in weakened and elderly patients and low-weight infants. (15,16) In addition, some species produce a slime layer of polysaccharides that increases the bacterial adhesion to the different surfaces and is related to the formation of biofilms. (17,18) The susceptibility profile of the Staphylococcus revealed that, of all isolated strains, 61.5% were oxacillin-resistant.…”

Effects of zinc oxide nanoparticles on Kupffer cell phagosomal motility, bacterial clearance, and liver function

“…The IV route was chosen because it is a common method of administration for both antimicrobial and anticancer drugs. Pseudomonas aeruginosa is one of the most common nosocomial causes of Gram-negative infections and bacteremia, 33 and thus it is especially relevant to patients with septicemia or undergoing IV therapies. To prepare the bacterial suspension for IV injection, an aliquot of a stock of P. aeruginosa was added to tubes containing tryptic soy broth.…”