Epidemiology of hospital-acquired bloodstream infections in a Tunisian pediatric intensive care unit: A 2-year prospective study

Jaballah, Nejla Ben; Bouziri, Asma; Mnif, Khaled; Hamdi, Abdelaziz; Khaldi, Abdelhamid; Kchaou, W.

doi:10.1016/j.ajic.2006.09.007

Cited by 38 publications

(34 citation statements)

References 27 publications

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“…One possible explanation is that CoNS is a low virulence pathogen. According to Ben Jaballah 17 , high resistance to third generation cephalosporin by Gram-negative bacilli has increased, including Acinetobacter sp, Enterobacter sp, Serratia marcescens and Klebsiella pneumonia; however, it should be noted that only a small number of GNB samples were isolated in this study.…”

Section: Discussionmentioning

confidence: 73%

Nosocomial infections in a Brazilian neonatal intensive care unit: a 4-year surveillance study

Brito

Resende

et al. 2010

Rev. Soc. Bras. Med. Trop.

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Introduction: Report the incidence of nosocomial infections, causative microorganisms, risk factors associated with and antimicrobial susceptibility pattern in the NICU of the Uberlândia University Hospital. Methods‫׃‬ Data were collected through the National Healthcare Safety Network surveillance from January 2006 to December 2009. The patients were followed five times/week from their birth to their discharge or death. Results‫׃‬ The study included 1,443 patients, 209 of these developed NIs, totaling 293 NI episodes, principally bloodstream infections (203; 69.3%) and conjunctivitis (52; 17.7%). Device-associated infection rates were as follows: 17.3 primary bloodstream infections per 1,000 central line-days and 3.2 pneumonias per 1000 ventilator-days. The mortality rate in neonates with NI was 11.9%. Mechanical ventilation, total parenteral nutrition, orogastric tube, previous antibiotic therapy, use of CVC and birth weight of 751-1,000g appeared to be associated with a significantly higher risk of NI (p ≤ 0.05). In multiple logistic regression analysis for NI, mechanical ventilation and the use of CVC were independent risk factors (p ≤ 0.05). Coagulase-negative Staphylococcus (CoNS) (36.5%) and Staphylococcus aureus (23.6%) were the most common etiologic agents isolated from cultures. The incidences of oxacillin-resistant CoNS and S. aureus were 81.8% and 25.3%, respectively. Conclusions‫׃‬ Frequent surveillance was very important to evaluate the association of these well-known risk factors with NIs and causative organisms, assisting in drawing the attention of health care professionals to this potent cause of morbidity.

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Section: Discussionmentioning

confidence: 73%

Nosocomial infections in a Brazilian neonatal intensive care unit: a 4-year surveillance study

Brito

Resende

et al. 2010

Rev. Soc. Bras. Med. Trop.

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“…The findings of the INICC in Egypt from two PICUs were 22.8 DAHAIs per 1,000 ICU-days, 18.8 CLABSIs per 1,000 line-days, and 31.8 VAPs per 1,000 ventilator-days [14]. In a Tunisian PICU, the rate of CVC-associated infections was 14.8 per 1,000 catheter-days [15].…”

Section: Introductionmentioning

confidence: 99%

Device-associated infections in the pediatric intensive care unit at the American University of Beirut Medical Center

Ismail

Sleiman

Majdalani

et al. 2016

J Infect Dev Ctries

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Introduction: Device-associated healthcare-associated infections (DA-HAIs) are the principal threat to patient safety in intensive care units (ICUs). The primary objective of this study was to identify the most common DA-HAIs in the pediatric intensive care unit (PICU) at the American University of Beirut Medical Center (AUBMC). Length of stay (LOS) and mortality, antimicrobial resistance patterns, and suitability of empiric antibiotic choices for DA-HAIs according to the local resistance patterns were also studied. Methodology: This was a retrospective study that included all patients admitted to the PICU at AUBMC between January 2007 and December 2011. All patients admitted to the PICU having a placed central line, an endotracheal tube, and/or a Foley catheter were included. Data was extracted from the patients' medical records through chart review. A total of 22 patients were identified with 25 central line-associated bloodstream infections (CLABSI), 25 ventilator-associated pneumonia (VAP), and 9 catheter-associated urinary tract infections (CAUTIs). The causing organisms, their resistance patterns, and the appropriateness of empiric antimicrobial therapy were reported. Results: Gram-negative pathogens were found in 53% of the DA-HAIs, Gram-positive ones in 27%, and fungal organisms in 20%. A total of 80% of K. pneumonia isolates were extended-spectrum beta-lactamases (ESBL) producers, and 30% of Pseudomonas isolates were multidrug resistant. No methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE) were isolated. Based on culture results, the choice of empiric antimicrobial therapy was appropriate in 64% of the DA-HAIs. Conclusions: After the care bundle approach is adopted in our PICU, DA-HAIs are expected to decrease further.

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“…One possible explanation is that CoNS is a low-virulence pathogen. According to Ben Jaballah et al 15 , high resistance to third-generation cephalosporin by gram-negative bacilli has increased, including Acinetobacter sp, Enterobacter sp, Serratia marcescens, Klebsiella pneumoniae, and Pseudomonas aeruginosa. This was shown in some of our studies including detection of outbreaks of these pathogens [16][17][18] .…”

Section: Ethical Considerationsmentioning

confidence: 99%

Nosocomial infections in a neonatal intensive care unit during 16 years: 1997-2012

Urzedo

Levenhagen

Pedroso

et al. 2014

Rev. Soc. Bras. Med. Trop.

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Introduction: Surveillance of nosocomial infections (NIs) is an essential part of quality patient care; however, there are few reports of National Healthcare Safety Network (NHSN) surveillance in neonatal intensive care units (NICUs) and none in developing countries. The purpose of this study was to report the incidence of NIs, causative organisms, and antimicrobial susceptibility patterns in a large cohort of neonates admitted to the NICU during a 16-year period. Methods: The patients were followed 5 times per week from birth to discharge or death, and epidemiological surveillance was conducted according to the NHSN. Results: From January 1997 to December 2012, 4,615 neonates, representing 62,412 patient-days, were admitted to the NICU. The deviceassociated infection rates were as follows: 17.3 primary bloodstream infections per 1,000 central line-days and 3.2 pneumonia infections per 1,000 ventilator-days. A total of 1,182 microorganisms were isolated from sterile body site cultures in 902 neonates. Coagulase-negative staphylococci (CoNS) (34.3%) and Staphylococcus aureus (15.6%) were the most common etiologic agents isolated from cultures. The incidences of oxacillin-resistant CoNS and Staphylococcus aureus were 86.4% and 28.3%, respectively. Conclusions:The most important NI remains bloodstream infection with staphylococci as the predominant pathogens, observed at much higher rates than those reported in the literature. Multiresistant microorganisms, especially oxacillin-resistant staphylococci and gram-negative bacilli resistant to cephalosporin were frequently found. Furthermore, by promoting strict hygiene measures and meticulous care of the infected infants, the process itself of evaluating the causative organisms was valuable.

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Epidemiology of hospital-acquired bloodstream infections in a Tunisian pediatric intensive care unit: A 2-year prospective study

Cited by 38 publications

References 27 publications

Nosocomial infections in a Brazilian neonatal intensive care unit: a 4-year surveillance study

Nosocomial infections in a Brazilian neonatal intensive care unit: a 4-year surveillance study

Device-associated infections in the pediatric intensive care unit at the American University of Beirut Medical Center

Nosocomial infections in a neonatal intensive care unit during 16 years: 1997-2012

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