ABSTRACT
Nosocomial infections (NI) result in considerably high mortality and morbidity rates, especially among pediatric patients. Considering current worldwide changes, information about the occurrence of pathogens and susceptibility tests are now seen as decisive for optimizing treatment. The purpose of this research was to determine the frequency of microorganisms, antimicrobial and genetic profiles, and risk factors associated with nosocomial infections in a teaching hospital in Campo Grande, Mato Grosso do Sul. From January 1998 to December 1999, 108 patients were characterized as having nosocomial infection, from which 137 pathogens were isolated. Identification and antimicrobial susceptibility was determined by conventional and automated techniques. Staphylococcus aureus and Klebsiella pneumoniae strains were characterized by Pulsed Field Gel Electrophoresis (PFGE). Pathogens were most often isolated from infants one-month old or younger, and bloodstream infections were the most frequent. The main isolated agents isolated were: coagulase-negative staphylococci (38), Pseudomonas aeruginosa (19), S. aureus (26), K. pneumoniae (18), and Candida spp. (13). The risk conditions that were most closely related to NI acquisition were: prolonged hospital stays (69.4%), prematurity (60.9%) and exposure to high-risk device procedures (95.4%). Ciprofloxacin and imipenem were the most effective drugs, inhibiting all or almost all of the Enterobacteriaceae, P. aeruginosa and Acinetobacter calcoaceticus isolates. Only 23% of the S. aureus samples were resistant to oxacillin. Genomic typing revealed 10 distinct patterns for S. aureus and 13 for K. pneumoniae, suggesting that most them did not belong to the same clone. PFGE was effective in differentiating the strains.
Subject(s)
Anti-Bacterial Agents/pharmacology , Cross Infection/microbiology , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Age Factors , Brazil/epidemiology , Candida/isolation & purification , Child , Child, Preschool , Cross Infection/epidemiology , Drug Resistance, Bacterial , Drug Resistance, Fungal , Electrophoresis, Gel, Pulsed-Field , Female , Follow-Up Studies , Gram-Negative Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Hospitals, Pediatric , Hospitals, Teaching , Humans , Infant , Length of Stay , Male , Risk FactorsABSTRACT
Nosocomial infections (NI) result in considerably high mortality and morbidity rates, especially among pediatric patients. Considering current worldwide changes, information about the occurrence of pathogens and susceptibility tests are now seen as decisive for optimizing treatment. The purpose of this research was to determine the frequency of microorganisms, antimicrobial and genetic profiles, and risk factors associated with nosocomial infections in a teaching hospital in Campo Grande, Mato Grosso do Sul. From January 1998 to December 1999, 108 patients were characterized as having nosocomial infection, from which 137 pathogens were isolated. Identification and antimicrobial susceptibility was determined by conventional and automated techniques. Staphylococcus aureus and Klebsiella pneumoniae strains were characterized by Pulsed Field Gel Electrophoresis (PFGE). Pathogens were most often isolated from infants one-month old or younger, and bloodstream infections were the most frequent. The main isolated agents isolated were: coagulase-negative staphylococci (38), Pseudomonas aeruginosa (19), S. aureus (26), K. pneumoniae (18), and Candida spp. (13). The risk conditions that were most closely related to NI acquisition were: prolonged hospital stays (69.4 percent), prematurity (60.9 percent) and exposure to high-risk device procedures (95.4 percent). Ciprofloxacin and imipenem were the most effective drugs, inhibiting all or almost all of the Enterobacteriaceae, P. aeruginosa and Acinetobacter calcoaceticus isolates. Only 23 percent of the S. aureus samples were resistant to oxacillin. Genomic typing revealed 10 distinct patterns for S. aureus and 13 for K. pneumoniae, suggesting that most them did not belong to the same clone. PFGE was effective in differentiating the strains
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Anti-Bacterial Agents , Cross Infection , Drug Resistance, Bacterial , Gram-Negative Bacteria , Gram-Positive Bacteria , Hospitals, Pediatric , Age Factors , Brazil , Candida , Cross Infection , Drug Resistance, Fungal , Electrophoresis, Gel, Pulsed-Field , Follow-Up Studies , Gram-Negative Bacteria , Gram-Positive Bacteria , Hospitals, Teaching , Infection Control , Length of Stay , Microbial Sensitivity Tests , Risk FactorsABSTRACT
This study had the objective of to analyze the demographic and bacteriologic data of 32 hospitalized newborns in an neonatal intensive care unit of a public maternity hospital in Rio de Janeiro city, Brazil, seized by Pseudomonas aeruginosa sepsis during a period ranged from July 1997 to July 1999, and to determine the antimicrobial resistance percentage, serotypes and pulsed field gel electrophoresis (PFGE) patterns of 32 strains isolated during this period. The study group presented mean age of 12.5 days, with higher prevalence of hospital infection in males (59.4%) and vaginal delivery (81.2%), than females (40.6%) and cesarean delivery (18.8%), respectively. In this group, 20 (62.5%) patients received antimicrobials before positive blood cultures presentation. A total of 87.5% of the patients were premature, 62.5% presented very low birth weight and 40.6% had asphyxia. We detected high antimicrobial resistance percentage to b-lactams, chloramphenicol, trimethoprim/sulfamethoxazole and tetracycline among the isolated strains. All isolated strains were classified as multi-drug resistant. Most strains presented serotype O11 while PFGE analysis revealed seven distinct clones with isolation predominance of a single clone (75%) isolated from July 1997 to June 1998.
Subject(s)
Cross Infection/drug therapy , Drug Resistance, Bacterial/genetics , Intensive Care Units, Neonatal , Pseudomonas Infections/drug therapy , Pseudomonas aeruginosa/drug effects , Brazil , Case-Control Studies , Cross Infection/microbiology , Electrophoresis, Gel, Pulsed-Field , Female , Humans , Infant, Newborn , Male , Mutation , Pseudomonas aeruginosa/genetics , SerotypingABSTRACT
The dispersion of potentially pathogenic, antibiotic-resistant microorganisms via expressed human milk can be considered a risk factor. The aim of this study was to contribute to a better understanding of coliform isolates from expressed human milk and their antimicrobial resistance profiles. The sampling scheme followed a totally randomized design, using 837 samples of expressed human milk. Of these, 71 (8.48%) were identified as contaminated with total coliforms, although in none of the samples did the population exceed 1.0x10(3) MPN/ml. Most of the microorganisms isolated (91.6%) belonged to only two species, Enterobacter cloacae and Klebsiella pneumoniae, which when subjected to antibiograms, revealed that several strains showed prior resistance to some of the antimicrobials tested. Coliforms may grow in expressed human milk if it is improperly stored, depleting protection factors and reducing the milk's nutritional value.
Subject(s)
Enterobacteriaceae/drug effects , Milk Banks , Milk, Human/microbiology , Drug Resistance, Microbial , Enterobacteriaceae/isolation & purification , Escherichia coli/drug effects , Escherichia coli/isolation & purification , Humans , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/isolation & purificationABSTRACT
During a two years period, in this study was analyzed the demographic and bacteriologic data of 42 hospitalized newborns attempted by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae sepsis in a neonatal intensive care unit of a public maternity hospital in Rio de Janeiro, Brazil. The newborns mean age was 10.4 days, with a major prevalence of hospital infection in males (55.0%) than females (45.0%), and a major frequency in vaginal delivery (65.0%) than cesarean delivery (35.0%). 31 patients (77.5%) received a mean of 3 antimicrobials during a 7.9 days before positive blood cultures. The most important underlying risk conditions were prematurely (87.5%), very low birth weight (55.0%) and asphyxia (40.0%). Among the isolated strains were detected high resistance proportion to beta-lactams, aminoglycosides, chloramphenicol and trimethoprim-sulfamethoxazole. 6 distinct clones in a cluster of 42 epidemiologically related strains were detected through PFGE profiles. The isolated strains presented 9 different antimicrobial resistance profiles (ARPs), where the most frequent clones (A, B and D) were distributed in 5, 3 and 5 ARPs, respectively. Based in the PFGE profiles and isolation periods, apparently the clones A plus A1, B and D caused 3 distinct outbreaks during the study period.
Subject(s)
Bacterial Proteins/isolation & purification , Cross Infection/microbiology , Disease Outbreaks , Infant, Premature, Diseases/microbiology , Intensive Care Units, Neonatal , Klebsiella Infections/microbiology , Klebsiella pneumoniae/enzymology , beta-Lactam Resistance , beta-Lactamases/isolation & purification , Asphyxia Neonatorum/epidemiology , Bacterial Proteins/classification , Brazil/epidemiology , Comorbidity , Cross Infection/epidemiology , Drug Resistance, Multiple, Bacterial , Electrophoresis, Gel, Pulsed-Field , Female , Hospitals, Maternity/statistics & numerical data , Hospitals, Public/statistics & numerical data , Humans , Hyaline Membrane Disease/epidemiology , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases/epidemiology , Infant, Very Low Birth Weight , Intensive Care Units, Neonatal/statistics & numerical data , Klebsiella Infections/epidemiology , Klebsiella pneumoniae/isolation & purification , Male , Retrospective Studies , Risk Factors , Substrate Specificity , beta-Lactamases/classificationABSTRACT
Methicillin resistant Staphylococcus aureus (MRSA) is an organism that is frequently transmitted in hospitals and perinatal units. The MRSA is considered a public health problem in neonatology because of its strong potential for dissemination in the wards associated with high rates of morbidity and mortality. In this study we describe the bacteriological, epidemiological and molecular characteristics of MRSA isolated from anterior nares and blood cultures of newborns hospitalized in a public maternity hospital in the city of Rio de Janeiro, Brazil. The frequency of MRSA isolated from nasal swabs of newborns was 47.8 percent (43/90). The genetic analysis of MRSA strains from anterior nares, showed 8 different pulsed field gel electrophoresis patterns (PFGE). Upon analysis of PFGE patterns of the 12 MRSA strains isolated from blood cultures, 8 different patterns were observed, 9 (75 percent) strains were genetic related to nasal secretion isolates patterns. In conclusion, our data demonstrate the importance of screening of newborns for the presence of MRSA in Brazilian hospitals and the usefulness of genetic typing of these pathogen during epidemiologic studies. This should lead to a better knowledge on the significancy and spreading of MRSA in the hospitals
Subject(s)
Humans , Infant, Newborn , Methicillin Resistance/genetics , Staphylococcal Infections/epidemiology , Staphylococcus aureus/genetics , Brazil/epidemiology , Electrophoresis, Agar Gel/methods , Prospective Studies , Staphylococcus aureus/drug effectsABSTRACT
Methicillin resistant Staphylococcus aureus (MRSA) is an organism that is frequently transmitted in hospitals and perinatal units. The MRSA is considered a public health problem in neonatology because of its strong potential for dissemination in the wards associated with high rates of morbidity and mortality. In this study we describe the bacteriological, epidemiological and molecular characteristics of MRSA isolated from anterior nares and blood cultures of newborns hospitalized in a public maternity hospital in the city of Rio de Janeiro, Brazil. The frequency of MRSA isolated from nasal swabs of newborns was 47.8% (43/90). The genetic analysis of MRSA strains from anterior nares, showed 8 different pulsed field gel electrophoresis patterns (PFGE). Upon analysis of PFGE patterns of the 12 MRSA strains isolated from blood cultures, 8 different patterns were observed, 9 (75%) strains were genetic related to nasal secretion isolates patterns. In conclusion, our data demonstrate the importance of screening of newborns for the presence of MRSA in Brazilian hospitals and the usefulness of genetic typing of these pathogen during epidemiologic studies. This should lead to a better knowledge on the significancy and spreading of MRSA in the hospitals.
Subject(s)
Cross Infection/microbiology , Methicillin Resistance/genetics , Staphylococcal Infections/microbiology , Staphylococcus aureus/genetics , Brazil/epidemiology , Cross Infection/epidemiology , Electrophoresis, Agar Gel/methods , Humans , Infant, Newborn , Prospective Studies , Staphylococcal Infections/epidemiology , Staphylococcus aureus/drug effectsABSTRACT
We dissected the digestive tract of 245 females in pools of 35 flies forming 7 groups. These flies were Lutzomyia longipalpis originating from Lapinha Cave, Lagoa Santa, Minas Gerais. Out of the 8 species of bacteria isolated there was a predominancy of Gram negative bacterias (GNB) in the group of non-fermenters of sugar belonging to the following species: Acinetobacter lwoffii, Stenotrophomonas maltophilia, Pseudomonas putida and Flavimonas orizihabitans. The group of GNB fermenters were: Enterobacter cloacae and Klebsiella ozaenae. In the Gram positive group we isolated the genera Bacillus thuringiensis and Staphylococcus spp.
Subject(s)
Psychodidae/microbiology , Animals , Brazil , PrevalenceABSTRACT
Hospital infections cause an increase in morbidity and mortality of hospitalized patients with significant rise in hospital costs. The aim of this work was an epidemiological analysis of hospital infection cases occurred in a public University Hospital in Rio de Janeiro. Hence, 238 strains were isolated from 14 different clinical materials of 166 patients hospitalized in the period between August 1995 and July 1997. The average age of the patients was 33.4 years, 72.9% used antimicrobials before having a positive culture. The most common risk conditions were surgery (19.3%), positive HIV or AIDS (18.1%) and lung disease (16.9%). 24 different bacterial species were identified, S. aureus (21%) and P. aeruginosa (18.5%) were predominant. Among 50 S. aureus isolated strains 36% were classified as MRSA (Methicillin Resistant S. aureus). The Gram negative bacteria presented high resistance to aminoglycosides and cephalosporins. A diarrhea outbreak, detected in high-risk neonatology ward, was caused by Salmonella serovar Infantis strain, with high antimicrobial resistance and a plasmid of high molecular weight (98Mda) containing virulence genes and positive for R factor.
