Nosocomial Bloodstream Infections in Brazilian Pediatric Patients: Microbiology, Epidemiology, and Clinical Features

Nosocomial Bloodstream Infections in Brazilian Pediatric Patients: Microbiology, Epidemiology, and Clinical Features

Author Pires Pereira, Carlos Alberto Google Scholar
Marra, Alexandre Rodrigues Autor UNIFESP Google Scholar
Camargo, Luis Fernando Aranha Autor UNIFESP Google Scholar
Pignatari, Antonio Carlos Campos Autor UNIFESP Google Scholar
Sukiennik, Teresa Google Scholar
Petersen Behar, Paulo Renato Google Scholar
Medeiros, Eduardo Alexandrino Servolo Autor UNIFESP Google Scholar
Ribeiro, Julival Google Scholar
Girao, Evelyne Google Scholar
Correa, Luci Google Scholar
Guerra, Carla Google Scholar
Carneiro, Irna Google Scholar
Brites, Carlos Google Scholar
Reis, Marise Google Scholar
Souza, Marta Antunes de Google Scholar
Tranchesi, Regina Google Scholar
Barata, Cristina U. Google Scholar
Edmond, Michael B. Google Scholar
Brazilian SCOPE Study Grp Google Scholar
Institution Inst Oncol Pediat IOP GRAAC
Hosp Israelita Albert Einstein
Universidade Federal de São Paulo (UNIFESP)
Hosp 9 Julho
Santa Casa Porto Alegre
Hosp Conceicao
Hosp Base
Hosp Walter Cantidio
Hosp Diadema
Hosp Espanhol
Hosp Coracao
Hosp UNIMED
Hosp Clin Goiania
Hosp Rim & Hipertensao
Univ Fed Triangulo Mineiro
Virginia Commonwealth Univ
Abstract Background: Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality and are the most frequent type of nosocomial infection in pediatric patients.Methods: 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).Results: 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.Conclusions: 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.
Language English
Sponsor Pfizer, Inc.
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Grant number FAPESP: 2006/57700-0
Date 2013-07-04
Published in Plos One. San Francisco: Public Library Science, v. 8, n. 7, 6 p., 2013.
ISSN 1932-6203 (Sherpa/Romeo, impact factor)
Publisher Public Library Science
Extent 6
Origin http://dx.doi.org/10.1371/journal.pone.0068144
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000323350700072
URI http://repositorio.unifesp.br/handle/11600/36536

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