Challenges and trends in Gram-negative bacterial infections in critically neonates: A seven-and-a-half-year observational study.

Autor: Ferreira ICDS; Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil., Machado ICB; Undergraduate Course in Biomedicine, Institute of Biomedical Sciences, 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, 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 09. Date of Electronic Publication: 2024 Aug 09.
DOI: 10.1016/j.ajic.2024.08.004
Abstrakt: Background: Analyze the incidence, risk factors, and fatality rates of bloodstream infections by Gram-negative bacteria (GNB-BSIs) in a Neonatal Intensive Care Unit.
Methods: This study employs a retrospective cohort design utilizing records of neonates admitted to the Neonatal Intensive Care Unit between January 2015 and June 2022.
Results: Among 1,495 neonates, 5.2% developed GNB-BSIs. The average incidence of infection per 1,000 patient-days was 2.9. Primary risk factors for infection that included preceeding carbapenem use were significant risk factors (odds ratio=514.4; P < .01) and fourth-generation cephalosporins (odds ratio=66; P < .01). Among the 85 GNB, 75.3% were fermenters, and 24.7% were non-fermenters. Of the isolates, 14.1% produced extended-spectrum beta-lactamase, and 2.3% carbapenem-resistant. Infection correlated with prolonged hospital stays (10-39days) and increased mortality (10%-29.9%).
Conclusions: The high incidence of GNB-BSIs was exacerbated by the preceeding use of broad-spectrum antimicrobials, increasing the presence of multidrug-resistant isolates and fatality rates. These findings emphasize the importance of active surveillance.
(Copyright © 2024 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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