ABSTRACT
Abstract INTRODUCTION: Multi-drug-resistant bacteria surveillance (MDR) systems are used to identify the epidemiology of MDR bacteria in neonates and children. This study aimed to describe the patterns by which MDR bacteria colonize and infect neonatal (NICU) and pediatric intensive care unit (PICU) patients in the state of Rio de Janeiro State, Brazil. METHODS A cross-sectional survey was performed using electronic data on NICU and PICU patients reported to the Rio de Janeiro State MDR bacteria surveillance system. All healthcare institutions that reported at least one case during the study period were included. RESULTS Between 2014 and 2017, 10,210 MDR bacteria cases, including 9261 colonizations and 949 infections, were reported. Among the colonizations, 5379 occurred in NICUs and 3882 in PICUs, while 405 infections occurred in NICUs and 544 in PICUs. ESBL producing Klebsiella sp and E. coli were the most reported colonization-causing agents in NICUs (1983/5379, 36.9%) and PICUs (1494/3882; 38.5%). The main causing bacteria reported in catheter-associated bloodstream infection (CLABSI), ventilator associated pneumonia, and catheter-associated urinary tract infection in NICUs were Klebsiella sp and E.coli (56/156, 35.9%), carbapenem-resistant Gram-negative bacteria (CRGNB) (22/65, 33.9%), and CRGNB (11/36, 30.6%) respectively, while in PICUs, they were MRSA (53/169, 31.4%), CRGNB (50/87, 57.4%), Klebsiella sp and E.coli (18/52, 34.6%), respectively. CONCLUSIONS MDR Gram-negative bacteria (ESBL producers and carbapenem-resistant bacteria) were the most reported agents among MDR bacteria reported to Rio de Janeiro surveillance system. Except for CLABSI in children, they caused all device-associated infections in NICUs and PICUs.
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Cross Infection/microbiology , Gram-Positive Bacterial Infections/microbiology , Gram-Negative Bacterial Infections/microbiology , Drug Resistance, Multiple, Bacterial , Intensive Care Units, Neonatal , Cross-Sectional Studies , Gram-Positive Bacterial Infections/classification , Gram-Negative Bacterial Infections/classification , Epidemiological MonitoringABSTRACT
Abstract Introduction: Extracorporeal membrane oxygenation (ECMO) has become a standard technique over the past few decades in intensive care unit (ICU). Objective: A review of pediatric patients who received ECMO support in the pediatric cardiac ICU was conducted to determine the incidence, risk factors and causal organisms related to acquired infections and assess the survival rates of ECMO patients with nosocomial infections. Methods: Sixty-six patients who received ECMO support in the pediatric cardiac ICU between January 2011 and June 2014 were included in the study. Demographic, echocardiographic, hemodynamic features and surgical procedures were reviewed. Results: Sixty-six patients received a total of 292.5 days of venoarterial ECMO support. Sixty were postoperative patients. Forty-five patients were weaned from ECMO support with an ECMO survival rate of 68.2%. The rate of infection was 116.2/1000 ECMO days. Prolonged ICU stay, duration of ventilation and ECMO were found associated with development of nosocomial infection and only the duration of ECMO was an independent risk factor for nosocomial infections in ECMO patients. Conclusion: The correction of the underlying process leading to ECMO support and shortening the length of ECMO duration together with stricter application of ECMO indications would improve the infection incidence and hospital surveillance of the patient group.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Extracorporeal Membrane Oxygenation/adverse effects , Cross Infection/etiology , Extracorporeal Membrane Oxygenation/mortality , Extracorporeal Membrane Oxygenation/statistics & numerical data , Intensive Care Units, Pediatric , Cross Infection/microbiology , Cross Infection/prevention & control , Cross Infection/epidemiology , Epidemiologic Methods , Gram-Negative Bacterial Infections/classification , Gram-Negative Bacterial Infections/microbiology , Gram-Negative Bacterial Infections/prevention & control , Gram-Negative Bacterial Infections/epidemiology , Gram-Negative Bacteria/isolation & purificationABSTRACT
Background : Community periodontal index of treatment needs (CPITN) index is commonly used to measure periodontal disease. It's uniqueness, apart from assessing the periodontal status, also gives the treatment needs for the underlying condition. Benzoyl-DL-arginine napthylamide (BANA) test is a chair side diagnostic test used to detect the presence of putative periodontal pathogens. We correlated the CPITN scores of patients with BANA test results to assess the validity of CPITN as an indicator of anaerobic periodontal infection. Objectives : The present study was aimed to correlate the CPITN scores with the BANA activity of subgingival plaque. The objective was to assess the validity of CPITN index as indicator of anaerobic periodontal infection. Patients and Methods : A total of 80 sites were selected from 20 patients with generalized chronic periodontitis. After measuring the probing depth with CPITN C probe, the highest score from each sextant was selected according to the CPITN criteria and subgingival plaque samples were collected using a sterile curette and the BANA test was performed. Results : Kendall's tau-b and Chi- square test were used to assess the correlation between the BANA test results and CPITN scores. Results indicated sensitivity (92.86%), specificity (80%) and agreement (91.25%); indicating the validity of CPITN in assessing anaerobic infection. Conclusion : There was a significant correlation between BANA test results and scores 3 and score 4 of CPITN index (P < 0.001) clearly indicating the presence of anaerobic periodontal infection.
Subject(s)
Adult , Bacteria, Anaerobic/physiology , Bacteroidaceae Infections/diagnosis , Bacteroides/classification , Bacteroides Infections/diagnosis , Benzoylarginine-2-Naphthylamide/diagnosis , Chronic Periodontitis/classification , Chronic Periodontitis/microbiology , Dental Plaque/microbiology , Gram-Negative Bacterial Infections/classification , Gram-Negative Bacterial Infections/diagnosis , Humans , Indicators and Reagents , Needs Assessment , Periodontal Attachment Loss/classification , Periodontal Attachment Loss/microbiology , Periodontal Index , Periodontal Pocket/classification , Periodontal Pocket/microbiology , Porphyromonas gingivalis/isolation & purification , Reproducibility of Results , Sensitivity and Specificity , Treponema denticola/isolation & purification , Treponemal Infections/diagnosisABSTRACT
El trabajo comportamiento de acinetobacter en los procesos infecciosos de pacientes ingresados al HEALF de enero de 2004- diciembre de 2005, se realizó con el objetivo de conocer el comportamiento de esta bacteria en nuestro medio ya que el acinetobacter ha surgido como un importante microorganismo a nivel intrahospitalario y uno de los mayores problemas de la infecciones producidas por esta bacteria es su tratamiento, por su amplia multiresistencia y por las pocas alternativas terapéuticas disponibles en la actualidad. Dicho estudio es descriptivo, de serie de casos. Para alcanzar este objetivo se estudiaron 452 pacientes a los que se aisló 528 Acinetobacter. Los procesos infewcciosos más frecuentes fueron: Sepsis de Herida Quirúrgica, Neumonías y Traqueóbronquitis. Los servicios más afectados fueron: Medicina Interna y de esta, la sala de UCI (Unidad de cuidados intensivos), Neurocirugía, principalmente lka sala de Neurocirugía Intermedios y cirugía plástica principalmente la sala de quemados. Según los resultados de Antibiogrma se encontró un alto grado de resistencia de la bacteria a los antibióticos disponibles en la Lista Básica de Medicamentos como son: Ceftriazona, Ampicilina, Amikacina, Ceftazidima y en menor grado de resistencia a los Carbapemenes (Imipenem, Meropenem)...>