Nosocomial infection surveillance in an Egyptian neonatal intensive care unit

Abdel-Wahab, F; Ghoneim, Mohamed A.; Khashaba, Mohamed; El‐Gilany, Abdel‐Hady; Abdel-Hady, Dina

doi:10.1016/j.jhin.2012.10.017

Cited by 48 publications

(31 citation statements)

References 19 publications

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“…In another descriptive hospital-based study carried out for 12 months in the NICU of the Mansoura University Children's Hospital, the investigators reported that Klebsiella spp. were the most frequently isolated organisms followed by E. coli [14] which is consistent with the results of previous Egyptian studies [23, 24]. …”

Section: Discussionsupporting

confidence: 91%

“…Ho and his coworkers [8] considered BSIs the most common source of infection as they represented 59.0% and 5.6% of these were catheter-related [8]. On the other hand, in a recent study in Egypt, pneumonia was the most frequently occurring infection (11.3%) followed by blood stream infection (8.8%) in NICU [14] which comes in agreement with the two Brazilian studies [15, 16]. However, in developed countries the distribution of nosocomial infections in neonates is different, with BSI predominating, followed by pneumonia [15, 17, 18].…”

Section: Discussionmentioning

confidence: 99%

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Pattern of Blood Stream Infections within Neonatal Intensive Care Unit, Suez Canal University Hospital, Ismailia, Egypt

Kishk

Mandour

Farghaly

et al. 2014

International Journal of Microbiology

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Introduction. Blood stream infection (BSI) is a common problem of newborn in neonatal intensive care units (NICUs). Monitoring neonatal infections is increasingly regarded as an important contributor to safe and high-quality healthcare. It results in high mortality rate and serious complications. So, our aim was to determine the incidence and the pattern of BSIs in the NICU of Suez Canal University Hospital, Egypt, and to determine its impact on hospitalization, mortality, and morbidity. Methods. This study was a prospective one in which all neonates admitted to the NICUs in Suez Canal University hospital between January, 2013 and June 2013 were enrolled. Blood stream infections were monitored prospectively. The health care associated infection rate, mortality rate, causative organism, and risk factors were studied. Results. A total of 317 neonates were admitted to the NICU with a mortality rate of 36.0%. During this study period, 115/317 (36.3%) developed clinical signs of sepsis and were confirmed as BSIs by blood culture in only 90 neonates with 97 isolates. The total mean length of stay was significantly longer among infected than noninfected neonates (34.5 ± 18.3 and 10.8 ± 9.9 days, resp., P value < 0.001). The overall mortality rates among infected and noninfected neonates were 38.9% and 34.8%, respectively, with a significant difference. Klebsiella spp. were the most common pathogen (27.8%) followed by Pseudomonas (21.6%) and Staphylococcus aureus (15.4%). Conclusion. The rate of BSIs in NICU at Suez Canal University Hospital was relatively high with high mortality rate (36.0%).

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Pattern of Blood Stream Infections within Neonatal Intensive Care Unit, Suez Canal University Hospital, Ismailia, Egypt

Kishk

Mandour

Farghaly

et al. 2014

International Journal of Microbiology

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“…In the Mansoura University Children’s Hospital NICU in Egypt, nosocomial infection is a significant problem [13]. Gram-negative bacteria, especially Klebsiella spp .…”

Section: Causes Of Neonatal Pneumoniamentioning

confidence: 99%

Neonatal pneumonia in sub-Saharan Africa

Green

Kolberg

2016

pneumonia

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Neonatal pneumonia is a devastating condition. Most deaths in sub-Saharan Africa can be attributed to preventable diseases, including pneumonia, diarrhoea and malaria, which together killed an estimated 2.2 million children under the age of 5 years in 2012, accounting for a third of all under-five deaths in this region. Some countries are making progress in reducing mortality through community-based health schemes; however, most countries in this region are far from achieving the World Health Organization Sustainable Development Goals for reducing childhood morbidity and mortality. The microorganisms causing neonatal pneumonia are well known. Both bacteria and viruses are commonly responsible, while fungal organisms occur in the context of nosocomial disease, and parasites occur in HIV-infected children. The common bacterial pathogens are group B streptococci (and other streptococcal species) and Gram-negative organisms, most notably Escherichia coli and Klebsiella spp. The viruses that predominate are the common respiratory pathogens, namely respiratory syncytial virus, human rhinovirus, and influenza virus. Viral disease is often nosocomial and transmitted to infected neonates in the neonatal intensive care unit or other neonatal facilities by infected parents and staff. Neonatal pneumonia often presents with non-specific respiratory distress in newborns. In the premature infant it is often indistinguishable from surfactant deficiency-associated respiratory distress syndrome. Therefore, diagnostic testing that is cheap and reliable is urgently sought in this region. All neonates with pneumonia must receive broad-spectrum antibiotic cover. This usually entails the combination of penicillin and an aminoglycoside. A lack of appropriate drugs and neonatal intensive care unit facilities are hampering progress in managing neonatal pneumonia.

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“…K. pneumoniae is considered one of the most common Gram negative bacteria2. It is also an important pathogen in nosocomial infections in Egypt34. A number of factors contribute to virulence and pathogenicity in K. pneumoniae such as the capsular serotype, lipopolysaccharide, iron-scavenging systems and adhesions5.…”

mentioning

confidence: 99%

Molecular typing and virulence analysis of multidrug resistant Klebsiella pneumoniae clinical isolates recovered from Egyptian hospitals

Wasfi

Elkhatib

Ashour

2016

Sci Rep

140

104

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Klebsiella pneumonia infection rates have increased dramatically. Molecular typing and virulence analysis are powerful tools that can shed light on Klebsiella pneumonia infections. Whereas 77.7% (28/36) of clinical isolates indicated multidrug resistant (MDR) patterns, 50% (18/36) indicated carpabenem resistance. Gene prevalence for the AcrAB efflux pump (82.14%) was more than that of the mdtK efflux pump (32.14%) in the MDR isolates. FimH-1 and mrkD genes were prevalent in wound and blood isolates. FimH-1 gene was prevalent in sputum while mrkD gene was prevalent in urine. Serum resistance associated with outer membrane protein coding gene (traT) was found in all blood isolates. IucC, entB, and Irp-1 were detected in 32.14%, 78.5% and 10.7% of MDR isolates, respectively. We used two Polymerase Chain Reaction (PCR) analyses: Enterobacterial Repetitive Intergenic Consensus (ERIC) and Random Amplified Polymorphic DNA (RAPD). ERIC-PCR revealed 21 and RAPD-PCR revealed 18 distinct patterns of isolates with similarity ≥80%. ERIC genotyping significantly correlated with resistance patterns and virulence determinants. RAPD genotyping significantly correlated with resistance patterns but not with virulence determinants. Both RAPD and ERIC genotyping methods had no correlation with the capsule types. These findings can help up better predict MDR Klebsiella pneumoniae outbreaks associated with specific genotyping patterns.

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Nosocomial infection surveillance in an Egyptian neonatal intensive care unit

Cited by 48 publications

References 19 publications

Pattern of Blood Stream Infections within Neonatal Intensive Care Unit, Suez Canal University Hospital, Ismailia, Egypt

Pattern of Blood Stream Infections within Neonatal Intensive Care Unit, Suez Canal University Hospital, Ismailia, Egypt

Neonatal pneumonia in sub-Saharan Africa

Molecular typing and virulence analysis of multidrug resistant Klebsiella pneumoniae clinical isolates recovered from Egyptian hospitals

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