Bloodstream infections and antimicrobial resistance patterns in a South African neonatal intensive care unit
| Autor: | G. Kirsten, G. Morkel, Angela Dramowski, J. van Wyk, Ben J. Marais, Adrie Bekker |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Antifungal Agents Neonatal intensive care unit medicine.drug_class Antibiotics Bacteremia medicine.disease_cause South Africa Antibiotic resistance Drug Resistance Fungal Pregnancy Intensive Care Units Neonatal Intensive care Drug Resistance Bacterial Prevalence medicine Humans Infection control Blood culture Retrospective Studies Cross Infection Bacteria medicine.diagnostic_test biology business.industry Fungi Infant Newborn Acinetobacter bacterial infections and mycoses biology.organism_classification Survival Analysis Anti-Bacterial Agents Staphylococcus aureus Pediatrics Perinatology and Child Health Female business Fungemia |
| Zdroj: | Paediatrics and International Child Health. 34:108-114 |
| ISSN: | 2046-9055 2046-9047 |
| DOI: | 10.1179/2046905513y.0000000082 |
| Popis: | Background: Bloodstream infections remain a leading cause of morbidity and mortality in neonatal intensive care units (NICU) worldwide. Commonly isolated NICU pathogens are increasingly resistant to standard antimicrobial treatment regimes. Objectives: The primary aim of this study was to determine the burden of bloodstream infections (BSI) in an NICU in a low-to-middle-income country and to describe the spectrum of pathogens isolated together with their drug susceptibility patterns. Methods: This retrospective, descriptive study included NICU patients admitted to the Tygerberg Children’s Hospital, Cape Town, between 1 January and 31 December 2008. All blood culture samples submitted to the reference laboratory were extracted and clinical data on patients were obtained by hospital record review. Results: There were 78 culture-confirmed episodes of BSI in 54/503 (11%) patients admitted; median gestational age was 31 weeks (IQR 29–37) and birth weight 1370 g (IQR 1040–2320). Common isolates included coagulase-negative Staphylococcus (22/78, 28%), Klebsiella spp. (17/78, 22%), Acinetobacter spp. (14/78, 18%), Candida spp. (9/78, 11.5%) and methicillin-resistant Staphylococcus aureus (5/78, 6%). There was a predominance of gram-negative organisms (38/78, 48.7%). All Staphylococcus aureus isolates were methicillin-resistant and 59% of Klebsiella pneumoniae isolates were extended spectrum b-lactamase (ESBL) producers. Acinetobacter baumanii isolates showed low susceptibility to the aminoglycosides, carbapenems and cephalosporins. Of 54 infants admitted to the NICU with BSI, 25 (46%) died; 9/25 deaths (36%) were attributable solely to infection. Conclusion: Compared with overall mortality in the NICU, that attributable solely or partly to BSI was high. Many bacterial BSI isolates were resistant to current empiric antibiotic regimens. Regular microbiological and clinical surveillance of BSI in NICUs is required to inform appropriate antibiotic protocols and monitor the impact of infection prevention strategies. |
| Databáze: | OpenAIRE |
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