Multiresistant microorganism infection in newborns at an intermediate neonatal care unit and intensive care unit of reference: cross-sectional study

Flávio Henrique Alves De Lima Flávio Henrique Alves De Lima,Bruno Bordin Pelazza Bruno Bordin Pelazza,Cácia Régia De Paula Cácia Régia De Paula,Marinésia Aparecida Da Silva Marinésia Aparecida Da Silva,Maria Alves Barbosa Maria Alves Barbosa,Jade Alves De Souza Pacheco Jade Alves De Souza Pacheco,Guilherme Silva De Mendonça

doi:10.14393/bj-v36n6a2020-49980

Abstract

The objective was to describe the infection profile of multidrug-resistant organisms of newborns (NB), admitted to the neonatal intermediate care unit and the intensive care unit. It was a descriptive cross-sectional study of epidemiological nature, composed of 931 medical records and/or Hospital Infection Control Committee notification records, during the period of June to September 2012. Eight hundred and seventy newborns (NB) were admitted to the neonatal intensive care units and to intermediate care, with a final sample of 45 NB presenting bloodstream infections (BSI) caused by multiresistant microorganisms. From the analyses, the following results were highlighted: gestational age < 37 weeks in 42 (93.3%); low weight at birth between < 750g to 1.499g. The profile for resistance to enterobacteriaceae was 100% for cefepime and ceftazidime concerning non-fermenting gram-negative bacteria, it was found that (100%) of P.aeruginosa was resistant to aztreonam, (100%) of S. maltophilia resistant to ceftazidime and to gentamycin, however, (1.1%) of S. aureus isolates were resistant to oxacillin and (12.5%) of S. haemolyticus demonstrated a confirmed resistance to vancomycin. These results are worrying and express the importance of correct monitoring, and the need for producing a propaedeutic protocol in consensus with the multiprofessional team through the Hospital Infection Control Committee and managers, which is then implemented and regularly assessed by the service.

Highlights

The movement toward quality care and safety of the patient in health services has been the most important proposal from the World Health Organization (WHO) for the new millennium (BELELA-ANACLETO et al, 2013; CAVALCANTE; PADOVEZE, 2012).In this scenario, the use of new technologies in health, together with the practice of care, therapy, contamination by the microbiota of the environment and the immunocompromising of newborns (NB) in intermediate care units (IMCU) and neonatal intensive care units (NICU)
The sample of newborns admitted to the IMCU and NICU of the study institution, with infection by multiresistant microorganisms, demonstrated that there was a predominance of admittances in the NICU (62.3%), male gender (64.4%), year of birth 2011 (57.8%), gestational age < 37 weeks (93.3%), birth weight of 1000 to 1499 Kg (35.5%), normal birth (53.3%) and mortality at 17.8%
The isolates of coagulase-negative staphylococci (CNS) in our study, 100% of S. capitis were resistant to ciprofloxacin, gentamycin, levofloxacin, oxacillin and penicillin; 100% of S. haemolyticus were resistant to erythromycin, levofloxacin, oxacillin and penicillin and 100% of S. hominiseram were resistant to ciprofloxacin, clindamycin, erythromycin, gentamycin and oxacillin and penicillin

Summary

Introduction

The movement toward quality care and safety of the patient in health services has been the most important proposal from the World Health Organization (WHO) for the new millennium (BELELA-ANACLETO et al, 2013; CAVALCANTE; PADOVEZE, 2012) In this scenario, the use of new technologies in health, together with the practice of care, therapy, contamination by the microbiota of the environment and the immunocompromising of newborns (NB) in intermediate care units (IMCU) and neonatal intensive care units (NICU). The use of new technologies in health, together with the practice of care, therapy, contamination by the microbiota of the environment and the immunocompromising of newborns (NB) in intermediate care units (IMCU) and neonatal intensive care units (NICU) These factors go on to favor cross-contamination and the development of infections, including health-careassociated infections (HCAIs), which are considered an adverse event (AE) of great impact on the health of the newborn (TOMAS et al, 2015; SILVA et al., 2016). Among others, on the fact that these microorganisms are notoriously involved in aggravating episodes, and become resistant to the antibiotics (ATB), included among these are Staphylococcus aureus, Staphylococcus Coagulase negative staphylococci (CNS), Enterococcus spp., Escherichia Coli, Klebsiela spp. and Enterobacter spp., Pseudo monasaeruginosa, Serratiamarcencens, Acinetobacter spp., Stenotrophomonas maltophilia and Candida ssp (SILVA et al, 2016; DE SÁ et al, 2019; MEDEIROS et al, 2015).

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