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Nosocomial Bloodstream Infections in Brazilian Pediatric Patients: Microbiology, Epidemiology, and Clinical Features
BACKGROUND: Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality and are the most frequent type of nosocomial infection in pediatric patients. METHODS: We identified the predominant pathogens and antimicrobial susceptibilities of nosocomial bloodstream isolates...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3701648/ https://www.ncbi.nlm.nih.gov/pubmed/23861860 http://dx.doi.org/10.1371/journal.pone.0068144 |
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author | Pereira, Carlos Alberto Pires Marra, Alexandre R. Camargo, Luis Fernando Aranha Pignatari, Antônio Carlos Campos Sukiennik, Teresa Behar, Paulo Renato Petersen Medeiros, Eduardo Alexandrino Servolo Ribeiro, Julival Girão, Evelyne Correa, Luci Guerra, Carla Carneiro, Irna Brites, Carlos Reis, Marise de Souza, Marta Antunes Tranchesi, Regina Barata, Cristina U. Edmond, Michael B. |
author_facet | Pereira, Carlos Alberto Pires Marra, Alexandre R. Camargo, Luis Fernando Aranha Pignatari, Antônio Carlos Campos Sukiennik, Teresa Behar, Paulo Renato Petersen Medeiros, Eduardo Alexandrino Servolo Ribeiro, Julival Girão, Evelyne Correa, Luci Guerra, Carla Carneiro, Irna Brites, Carlos Reis, Marise de Souza, Marta Antunes Tranchesi, Regina Barata, Cristina U. Edmond, Michael B. |
author_sort | Pereira, Carlos Alberto Pires |
collection | PubMed |
description | BACKGROUND: Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality and are the most frequent type of nosocomial infection in pediatric patients. METHODS: We identified the predominant pathogens and antimicrobial susceptibilities of nosocomial bloodstream isolates in pediatric patients (≤16 years of age) in the Brazilian Prospective Surveillance for nBSIs at 16 hospitals from 12 June 2007 to 31 March 2010 (Br SCOPE project). RESULTS: In our study a total of 2,563 cases of nBSI were reported by hospitals participating in the Br SCOPE project. Among these, 342 clinically significant episodes of BSI were identified in pediatric patients (≤16 years of age). Ninety-six percent of BSIs were monomicrobial. Gram-negative organisms caused 49.0% of these BSIs, Gram-positive organisms caused 42.6%, and fungi caused 8.4%. The most common pathogens were Coagulase-negative staphylococci (CoNS) (21.3%), Klebsiella spp. (15.7%), Staphylococcus aureus (10.6%), and Acinetobacter spp. (9.2%). The crude mortality was 21.6% (74 of 342). Forty-five percent of nBSIs occurred in a pediatric or neonatal intensive-care unit (ICU). The most frequent underlying conditions were malignancy, in 95 patients (27.8%). Among the potential factors predisposing patients to BSI, central venous catheters were the most frequent (66.4%). Methicillin resistance was detected in 37 S. aureus isolates (27.1%). Of the Klebsiella spp. isolates, 43.2% were resistant to ceftriaxone. Of the Acinetobacter spp. and Pseudomonas aeruginosa isolates, 42.9% and 21.4%, respectively, were resistant to imipenem. CONCLUSIONS: In our multicenter study, we found a high mortality and a large proportion of gram-negative bacilli with elevated levels of resistance in pediatric patients. |
format | Online Article Text |
id | pubmed-3701648 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-37016482013-07-16 Nosocomial Bloodstream Infections in Brazilian Pediatric Patients: Microbiology, Epidemiology, and Clinical Features Pereira, Carlos Alberto Pires Marra, Alexandre R. Camargo, Luis Fernando Aranha Pignatari, Antônio Carlos Campos Sukiennik, Teresa Behar, Paulo Renato Petersen Medeiros, Eduardo Alexandrino Servolo Ribeiro, Julival Girão, Evelyne Correa, Luci Guerra, Carla Carneiro, Irna Brites, Carlos Reis, Marise de Souza, Marta Antunes Tranchesi, Regina Barata, Cristina U. Edmond, Michael B. PLoS One Research Article BACKGROUND: Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality and are the most frequent type of nosocomial infection in pediatric patients. METHODS: We identified the predominant pathogens and antimicrobial susceptibilities of nosocomial bloodstream isolates in pediatric patients (≤16 years of age) in the Brazilian Prospective Surveillance for nBSIs at 16 hospitals from 12 June 2007 to 31 March 2010 (Br SCOPE project). RESULTS: In our study a total of 2,563 cases of nBSI were reported by hospitals participating in the Br SCOPE project. Among these, 342 clinically significant episodes of BSI were identified in pediatric patients (≤16 years of age). Ninety-six percent of BSIs were monomicrobial. Gram-negative organisms caused 49.0% of these BSIs, Gram-positive organisms caused 42.6%, and fungi caused 8.4%. The most common pathogens were Coagulase-negative staphylococci (CoNS) (21.3%), Klebsiella spp. (15.7%), Staphylococcus aureus (10.6%), and Acinetobacter spp. (9.2%). The crude mortality was 21.6% (74 of 342). Forty-five percent of nBSIs occurred in a pediatric or neonatal intensive-care unit (ICU). The most frequent underlying conditions were malignancy, in 95 patients (27.8%). Among the potential factors predisposing patients to BSI, central venous catheters were the most frequent (66.4%). Methicillin resistance was detected in 37 S. aureus isolates (27.1%). Of the Klebsiella spp. isolates, 43.2% were resistant to ceftriaxone. Of the Acinetobacter spp. and Pseudomonas aeruginosa isolates, 42.9% and 21.4%, respectively, were resistant to imipenem. CONCLUSIONS: In our multicenter study, we found a high mortality and a large proportion of gram-negative bacilli with elevated levels of resistance in pediatric patients. Public Library of Science 2013-07-04 /pmc/articles/PMC3701648/ /pubmed/23861860 http://dx.doi.org/10.1371/journal.pone.0068144 Text en © 2013 Pereira et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Pereira, Carlos Alberto Pires Marra, Alexandre R. Camargo, Luis Fernando Aranha Pignatari, Antônio Carlos Campos Sukiennik, Teresa Behar, Paulo Renato Petersen Medeiros, Eduardo Alexandrino Servolo Ribeiro, Julival Girão, Evelyne Correa, Luci Guerra, Carla Carneiro, Irna Brites, Carlos Reis, Marise de Souza, Marta Antunes Tranchesi, Regina Barata, Cristina U. Edmond, Michael B. Nosocomial Bloodstream Infections in Brazilian Pediatric Patients: Microbiology, Epidemiology, and Clinical Features |
title | Nosocomial Bloodstream Infections in Brazilian Pediatric Patients: Microbiology, Epidemiology, and Clinical Features |
title_full | Nosocomial Bloodstream Infections in Brazilian Pediatric Patients: Microbiology, Epidemiology, and Clinical Features |
title_fullStr | Nosocomial Bloodstream Infections in Brazilian Pediatric Patients: Microbiology, Epidemiology, and Clinical Features |
title_full_unstemmed | Nosocomial Bloodstream Infections in Brazilian Pediatric Patients: Microbiology, Epidemiology, and Clinical Features |
title_short | Nosocomial Bloodstream Infections in Brazilian Pediatric Patients: Microbiology, Epidemiology, and Clinical Features |
title_sort | nosocomial bloodstream infections in brazilian pediatric patients: microbiology, epidemiology, and clinical features |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3701648/ https://www.ncbi.nlm.nih.gov/pubmed/23861860 http://dx.doi.org/10.1371/journal.pone.0068144 |
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