High frequency of multidrug-resistant gram-negative rods in 2 neonatal intensive care units in the Philippines.
Infect Control Hosp Epidemiol
; 30(6): 543-9, 2009 Jun.
Article
em En
| MEDLINE
| ID: mdl-19435448
ABSTRACT
BACKGROUND:
Although hospital-acquired infections appear to be a growing threat to the survival of newborns in the developing world, the epidemiology of this problem remains poorly characterized.METHODS:
During a 10-month period, we conducted prospective longitudinal surveillance for colonization and bloodstream infection caused by gram-negative rods among all infants hospitalized in the 2 largest neonatal intensive care units in Manila, the Philippines. We determined antibiotic susceptibilities and calculated adjusted odds ratios for risk factors for bacteremia by means of multivariate logistic regression.RESULTS:
Of 1,831 neonates enrolled during a 10-month period, 1,017 (55.5%) became newly colonized and 358 (19.6%) became bacteremic with a drug-resistant gram-negative rod, most commonly Klebsiella species, Enterobacter species, Acinetobacter species, and Pseudomonas aeruginosa. Of the invasive isolates, 20% were resistant to imipenem, 41% to trimethoprim-sulfamethoxazole, 52% to amikacin, 63% to ampicillin-sulbactam, 67% to ceftazidime, and 80% to tobramycin. The factors significantly associated with an increased risk of bacteremia were mechanical ventilation and prematurity. Additionally, colonization with a drug-resistant gram-negative rod was an independent risk factor for bacteremia (odds ratio, 1.4 [95% confidence interval, 1.0-1.9]).CONCLUSIONS:
Colonization with a drug-resistant gram-negative rod was an independent risk factor for sepsis. If our data are typical, the unusually high intensity of colonization pressure and disease caused by multidrug-resistant gram-negative rods at these 2 neonatal intensive care units indicates an emerging healthcare crisis in the developing world. Improved infection control methods are therefore critically needed in developing countries.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Portador Sadio
/
Unidades de Terapia Intensiva Neonatal
/
Infecções por Bactérias Gram-Negativas
/
Bacteriemia
/
Farmacorresistência Bacteriana Múltipla
/
Bactérias Gram-Negativas
/
Doenças do Prematuro
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Newborn
País/Região como assunto:
Asia
Idioma:
En
Revista:
Infect Control Hosp Epidemiol
Assunto da revista:
DOENCAS TRANSMISSIVEIS
/
ENFERMAGEM
/
EPIDEMIOLOGIA
/
HOSPITAIS
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Estados Unidos