ABSTRACT
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
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% (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.
