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Nosocomial bloodstream infections in Brazilian pediatric patients: microbiology, epidemiology, and clinical features
Journal article   Open access   Peer reviewed

Nosocomial bloodstream infections in Brazilian pediatric patients: microbiology, epidemiology, and clinical features

Carlos Alberto Pires Pereira, Alexandre R Marra, Luis Fernando Aranha Camargo, Antônio Carlos Campos Pignatari, Teresa Sukiennik, Paulo Renato Petersen Behar, Eduardo Alexandrino Servolo Medeiros, Julival Ribeiro, Evelyne Girão, Luci Correa, …
PloS one, Vol.8(7), e68144
2013
DOI: 10.1371/journal.pone.0068144
PMCID: PMC3701648
PMID: 23861860
url
https://doi.org/10.1371/journal.pone.0068144View
Published (Version of record) Open Access

Abstract

Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality and are the most frequent type of nosocomial infection in pediatric patients. 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). 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. 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.
 Humans Cross Infection - mortality Child, Preschool Bacteremia - mortality Infant Male Acinetobacter - drug effects Bacteremia - microbiology Gram-Negative Bacterial Infections - microbiology Anti-Bacterial Agents - therapeutic use Intensive Care Units, Neonatal Female Child Brazil - epidemiology Infant, Newborn Cross Infection - epidemiology Staphylococcus - growth & development Bacteremia - drug therapy Gram-Negative Bacterial Infections - drug therapy Staphylococcus - drug effects Cross Infection - drug therapy Acinetobacter - growth & development Epidemiological Monitoring Klebsiella - drug effects Klebsiella - growth & development Cross Infection - microbiology Survival Analysis Gram-Negative Bacterial Infections - epidemiology Bacteremia - epidemiology Gram-Negative Bacterial Infections - mortality

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