Colonization by multidrug-resistant microorganisms of hospitalized newborns and their mothers in the neonatal unit context.

INTRODUCTION: The mother plays a fundamental role in the constitution and regulation of her child's healthy microbiota, however, preterm newborns are separated from their mothers soon after birth and transferred to Neonatal Intensive Care Units, being exposed the constant risk for the development of multidrug-resistant microorganisms' infections. The aim of this study was to explore the multidrug-resistant microorganism colonization of hospitalized babies and their mothers in the neonatal unit context. METHODOLOGY: A prospective case study conducted with hospitalized babies and their mothers in the Neonatal Unit at a university hospital. The sample was composed of 433 binomials (mother-child). Colonization culture samples were taken at the moment of the baby's discharge, via two swabs in the oral, nasal, axillary, inguinal, and rectal regions. RESULTS: The colonization incidence among the binomials, 30 (6.9%) were both colonized by multi-resistant microorganisms. Mothers of colonized babies (24.4%) demonstrated a higher chance of colonization in comparison to mothers of non-colonized babies (11.9%) (p = 0.002). Relationships were drawn between baby colonization and prematurity, extremely low birth weight, and non-exclusive maternal breastfeeding (p<0.05). ESBL-producing Gram-negative microorganisms were more frequent in the cultures of the binomials, with 35.9% of the babies colonized with Klebsiella spp. ESBL and 42.0% of the mothers with Escherichia coli ESBL. Furthermore, 50% of the binomials were colonized with E. coli ESBL. CONCLUSION: The prematurity, extremely low birth weight, and non-exclusive breastfeeding at hospital discharge were associated with baby colonization by multidrug-resistant microorganism. Furthermore, mothers of colonized children presented higher chances of colonization.

Colonization profile and duration by multi-resistant organisms in a prospective cohort of newborns after hospital discharge.

The aim of this study was to determine the spontaneous decolonization period and characteristics in a prospective cohort of newborns colonized by multidrug-resistant organisms, after their discharge from the neonatal intensive care unit. Multidrug resistance is defined as bacterial non-susceptibility to ≥ 1 agent of ≥ 3 antimicrobial categories. In total, 618 newborns were included in the study, of which 173 (28.0%) presented a positive culture for multidrug-resistant microorganisms, and of these, 52 (30.1%) were followed up in this study. The most frequent intrinsic factors were be born by cesarean section (86.5%), prematurity (84.6%), and very low birth weight (76.9%). The extrinsic factors were having remained hospitalized for an average of 27 days, during which 67.3% were submitted to invasive procedures and 88.5% received antimicrobials. The intrinsic and extrinsic factors of newborns were not associated to a decolonization period longer or shorter than 3 months, which was the average period of decolonization found in the present study. From the totality of colonization cultures sampled at hospital discharge, the Gram-negative Extended Spectrum ß-lactamase producing bacteria were the most common, with 28.9% of babies colonized by Klebsiella spp. The median period of decolonization by multidrug-resistant microorganisms in the newborns population after hospital discharge was 3 months, but was highly dependent on the microbial species, and this period was not associated to any intrinsic and extrinsic factors of the newborn.

Exclusive breastfeeding in preterm infants at Child-Friendly hospitals: a comparative study / Aleitamento materno exclusivo em prematuros de hospitais Amigo da Criança: estudo comparativo / Lactancia materna exclusiva en prematuros de hospitales Amigo del Niño: estudio comparativo

AIM: to compare the prevalence of exclusive breastfeeding (EBF) and to verify the factors associated with its interruption in premature infants hospitalized at Baby-Friendly hospitals. METHOD: this is a comparative study performed with 107 premature infants admitted to the neonatal unit of two hospitals in Paraná. Data were obtained through interviews with mothers and analysis of infant records at hospital discharge and 15 days after delivery. RESULTS: the prevalence of EBF was 29.2% in the University Hospital and 15.3% in the Philanthropic Hospital. At hospital discharge, associations with clinical characteristics of infants predominated, and 15 days after discharge there was a greater association with the socio-demographic characteristics of the parents. CONCLUSION: the prevalence of EBF, which was shown to be low at the time of hospital discharge in both hospitals, decreased after discharge, reinforcing the need for other strategies, in addition to those provided at Baby-Friendly hospitals, for the promotion and support of EBF in preterm infants.

OBJETIVO: comparar a prevalência do aleitamento materno exclusivo (AME) e verificar os fatores associados à sua interrupção em prematuros internados em hospitais Amigo da Criança. MÉTODO: estudo comparativo com 107 prematuros internados na unidade neonatal de dois hospitais do Paraná. Dados obtidos por meio de entrevistas com as mães e análise de prontuários dos bebês, na alta hospitalar e 15 dias após a mesma. RESULTADOS: as prevalências do AME foram 29,2% no Hospital Universitário e 15,3% no Hospital Filantrópico. Na alta hospitalar, predominou as associações com características clínicas dos bebês, e 15 dias após a alta observou-se maior associação com as características sociodemográficas dos pais. CONCLUSÃO: a prevalência de AME, que se mostrou-se baixa no momento da alta hospitalar em ambos os hospitais, reduziu após a alta, reforçando que são necessárias outras estratégias, além daquelas previstas nos hospitais Amigo da Criança, para a promoção e apoio do AME em prematuros.

OBJETIVO: comparar la prevalencia de la lactancia materna exclusiva (LME) y verificar los factores asociados a su interrupción en prematuros internados en hospitales Amigo del Niño. MÉTODO: estudio comparativo con 107 prematuros internados en la unidad neonatal de dos hospitales de Paraná. Datos obtenidos por medio de entrevistas realizadas con las madres y el análisis de prontuarios de los bebés, en el alta hospitalaria y después de 15 días de la misma. RESULTADOS: las prevalencias de la LME fueron 29,2% en el Hospital Universitario y 15,3% en el Hospital Filantrópico. En el alta hospitalaria, predominó las asociaciones con características clínicas de los bebés, y 15 días después del alta se observó mayor asociación con las características sociodemográficas de los padres. CONCLUSIÓN: la prevalencia de la LME, que se mostró baja en el momento del alta hospitalaria en ambos hospitales, se redujo después del alta, reforzando que son necesarias otras estrategias, además de aquellas previstas en los hospitales Amigo del Niño, para promover y apoyar la LME en prematuros.