Five-year prospective surveillance of nosocomial bloodstream infections in an Estonian paediatric intensive care unit

Mitt, Piret; Metsvaht, Tuuli; Adamson, Vivika; Telling, Kaidi; Naaber, Paul; Lutsar, Irja; Maimets, Matti

doi:10.1016/j.jhin.2013.11.002

Cited by 21 publications

(17 citation statements)

References 24 publications

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“…(Karlowicz et al, 2000) Studies conducted by Makhoul et al (2005) showed that mortality rate was about 4 times higher for infections caused by E. coli and 6 times higher for K. pneumo niae than for CoNS infections. Gramnegative bacilli (GNB) have been shown to be the nondominant group of etiological risk factors for BSI, representing 20-30% of the infections in some studies (Graham et al, 2006;Mitt et al, 2014;Nagao, 2013). A study conducted by Cordero et al (2004) showed that 20% of BSI episodes were caused by GNB, of which 15% were Enterobacte riaceae.…”

Section: Discussionmentioning

confidence: 99%

Bloodstream Infections due to Enterobacteriaceae Among Neonates in Poland – Molecular Analysis of the Isolates

et al. 2015

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Bloodstream infections (BSIs) are associated with a significantly increased risk of fatality. No report has been found about the molecular epidemiology of Enterobacteriaceae causing BSI in neonates in Poland. The aim of this work was to determine the antibiotic resistance profiles, virulence gene prevalence, the epidemiological and genetic relationships among the isolates from Enterobacteriaceae causing BSI in neonates with birth weight < 1501 g. Antimicrobial susceptibility testing was performed. PCR was performed to identify the presence of common beta-lactamase genes, virulence genes. PFGE and MLST were performed. The surveillance group contained 1,695 newborns. The incidence rate for BSIs was 5.9%, the fatality rate 15%. The most common species were Escherichia coli (n = 24) and Klebsiella pneumoniae (n = 16). CTX-M-15 was found in 6 E. coli, 8 K. pneumoniae, 1 Enterobacter cloacae strains. Among E. coli fimH (83.3%), ibeA (37.5%), neuC (20.8%) were the most frequent. PFGE demonstrated unique pulsotypes among E. coli. E. coli ST131 clone was found in 7 E. coli strains. PFGE of 16 K. pneumoniae strains showed 8 pulsotypes. Five isolates from one NICU belonged to one clone. MLST typing revealed 7 different ST with ST336 as the most prevalent. This study provides information about resistance, virulence and typing of Enterobacteriaceae strains causing BSI among neonates. E. coli and Klebsiella spp. isolated in this study have completely different epidemiology from each other.

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Section: Discussionmentioning

confidence: 99%

Bloodstream Infections due to Enterobacteriaceae Among Neonates in Poland – Molecular Analysis of the Isolates

et al. 2015

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“…Caio Fernando de Oliveira [1] , Jorunn Pauline Cavanagh [2], [3] , Elizabeth G. Aarag Fredheim [2], [3] , Keli Cristine Reiter [4] , Alexandre Rieger [5] , Claus Klingenberg [3] , Pedro Alves d'Azevedo [4] and Johanna Ericson Sollid [6] [1]. Programa de Pós Graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brasil.…”

Section: Coagulase-negative Staphylococci In Southern Brazil: Lookingunclassified

“…of Clinical Medicine, Faculty of Health Sciences, UiT-The Artic University of Norway, Tromsø, Norway. [3]. Department of Paediatrics, University Hospital of North Norway, Tromsø, Norway.…”

Section: Coagulase-negative Staphylococci In Southern Brazil: Lookingmentioning

confidence: 99%

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Coagulase-negative staphylococci in Southern Brazil: looking toward its high diversity

Oliveira

Cavanagh

Fredheim

et al. 2016

Rev. Soc. Bras. Med. Trop.

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“…3,4 The impact of multidrug-resistant (MDR) organisms in pediatrics is increasing globally. [5][6][7] It is assumed that infections caused by MDR bacteria will have a worse prognosis because of the delay in the administration of appropriate therapy. However, it is difficult to estimate the clinical impact of MDR-HAI in children.…”

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confidence: 99%

Healthcare-Associated Infections in Pediatric and Neonatal Intensive Care Units: Impact of Underlying Risk Factors and Antimicrobial Resistance on 30-Day Case-Fatality in Italy and Brazil

Folgori

Bernaschi

Piga

et al. 2016

Infect. Control Hosp. Epidemiol.

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objectives. To describe trends in the epidemiology of healthcare-associated Infections (HAIs) in pediatric/neonatal intensive care units (ICUs) and to evaluate risk factors and impact of multidrug resistance in children admitted to ICUs.design. Multicenter, retrospective, cohort study with a nested case-control study conducted from January 1, 2010, through December 31, 2014.setting. Three tertiary care pediatric hospitals in Italy and Brazil with a total of 103 ICU beds.patients. Inclusion criteria were admission to ICU during the study period, age at onset less than 18 years, and microbiologically confirmed HAI.results. A total of 538 HAIs in 454 children were included; 93.3% of patients had comorbidities. Bloodstream infections were the leading pattern (45.4%). The cumulative incidence of HAI was 3.6/100 ICU admissions and the crude 30-day fatality rate was 5.7/1,000 admissions. The most frequently isolated pathogens were Enterobacteriaceae, followed by Pseudomonas aeruginosa and Staphylococcus aureus. Forty-four percent of isolates were multidrug-resistant (MDR). Two multivariate logistic regressions were performed. Factors independently associated with an MDR-HAI were country, previous antibiotics, transplantation, major surgery, and colonization by an MDR strain. Factors independently associated with 30-day case fatality were country, previous transplantation, fungal infection, bloodstream infection, lower respiratory tract infection, and infection caused by MDR strains.conclusions. Infection control and prevention can limit the spread of MDR strains and improve outcomes. Targeted surveillance programs collecting neonatal and pediatric HAI/bloodstream infection data and outcomes would allow global benchmarking. The next step is to identify methods to monitor key HAIs and integrate these into affordable intervention programs. 2016;37:1302-1309 Healthcare-associated infections (HAIs) are one of the most frequent adverse events affecting children admitted to intensive care units (ICUs). Infect Control Hosp Epidemiol1,2 Exposure to invasive devices and procedures, immune suppression, and underlying conditions are considered as main determinants of patients' increased susceptibility.3,4 The impact of multidrug-resistant (MDR) organisms in pediatrics is increasing globally. [5][6][7] It is assumed that infections caused by MDR bacteria will have a worse prognosis because of the delay in the administration of appropriate therapy. However, it is difficult to estimate the clinical impact of MDR-HAI in children.Previous literature has shown conflicting results about the impact of different underlying risk factors on the clinical outcome of patients with HAI admitted to ICUs. There is no clear independent correlation between antimicrobial resistance and patients' mortality. [8][9][10][11] Clarifying the relationship between patient risk factors and pediatric HAI mortality could allow improved targeting of interventions on the patients most at risk of adverse outcome. The aims of this study were to describe trends i...

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Five-year prospective surveillance of nosocomial bloodstream infections in an Estonian paediatric intensive care unit

Cited by 21 publications

References 24 publications

Bloodstream Infections due to Enterobacteriaceae Among Neonates in Poland – Molecular Analysis of the Isolates

Bloodstream Infections due to Enterobacteriaceae Among Neonates in Poland – Molecular Analysis of the Isolates

Coagulase-negative staphylococci in Southern Brazil: looking toward its high diversity

Healthcare-Associated Infections in Pediatric and Neonatal Intensive Care Units: Impact of Underlying Risk Factors and Antimicrobial Resistance on 30-Day Case-Fatality in Italy and Brazil

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