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Title: Nosocomial Bloodstream Infections in Brazilian Pediatric Patients: Microbiology, Epidemiology, and Clinical Features
Authors: Pires Pereira, Carlos Alberto
Marra, Alexandre Rodrigues [UNIFESP]
Camargo, Luis Fernando Aranha [UNIFESP]
Pignatari, Antonio Carlos Campos [UNIFESP]
Sukiennik, Teresa
Petersen Behar, Paulo Renato
Medeiros, Eduardo Alexandrino Servolo [UNIFESP]
Ribeiro, Julival
Girao, Evelyne
Correa, Luci
Guerra, Carla
Carneiro, Irna
Brites, Carlos
Reis, Marise
Souza, Marta Antunes de
Tranchesi, Regina
Barata, Cristina U.
Edmond, Michael B.
Brazilian SCOPE Study Grp
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 Clin Goiania
Hosp Rim & Hipertensao
Univ Fed Triangulo Mineiro
Virginia Commonwealth Univ
Issue Date: 4-Jul-2013
Publisher: Public Library Science
Citation: Plos One. San Francisco: Public Library Science, v. 8, n. 7, 6 p., 2013.
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.
ISSN: 1932-6203
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