Unraveling the epidemiology of urinary tract infections in neonates: Perspective from a Brazilian NICU.

Autor: Ferreira ICDS; Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil., Menezes RP; Technical Course in Clinical Analysis, Technical School of Health, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil. Electronic address: ralciane@ufu.br., Jesus TA; Undergraduate Course in Biomedicine, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil., Lopes MSM; Undergraduate Course in Biomedicine, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil., Araújo LB; Faculty of Mathematics, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil., Ferreira DMLM; Neonatal Intensive Care Unit, Hospital de Clínicas of the Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil., Röder DVDB; Department of Microbiology, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
Jazyk: angličtina
Zdroj: American journal of infection control [Am J Infect Control] 2024 Aug; Vol. 52 (8), pp. 925-933. Date of Electronic Publication: 2024 Mar 18.
DOI: 10.1016/j.ajic.2024.03.009
Abstrakt: Background: Urinary tract infections (UTIs) can lead to neonatal complications like sepsis, worsened by empirical treatment, contributing to antimicrobial resistance (AMR). This study examined the incidence, etiology, risk factors, and antimicrobial susceptibility of uropathogens in a Neonatal Intensive Care Unit (NICU) in Brazil.
Methods: Medical records of neonates hospitalized in the NICU from January 2015 to June 2022 were retrospectively analyzed through the National Healthcare Safety Network system.
Results: Among 1,474 neonates, 3.9% developed UTI, with an alarming 24-fold increase in incidence from 2015 to 2021. Genitourinary complications (odds ratio = 4.8) were a major risk factor. Of the 71 uropathogens, 74.6% were Gram-negative bacteria (GNB), 21.2% Gram-positive bacteria (GPB), and 4.2% Candida albicans. AMR was notable, with 13.3% of GPB and 20.7% of GNB exhibiting multidrug-resistant (MDR), while 6.6% of GPB and 1.9% of GNB showed extensive drug-resistant (XDR). UTI was associated with prolonged hospitalization (16-59 days). In 57 neonates with UTI, 40.3% had bloodstream infections, elevating the risk of death (odds ratio = 1.8).
Conclusions: The study underscores the urgency of implementing infection prevention and control measures in the NICU to curb rising UTI incidences, combat AMR, and mitigate severe complications in critically ill neonates.
(Copyright © 2024 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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