Patterns of antimicrobial resistance in a pediatric cardiac intensive care unit
Исследование антибиотикорезистентности в отделении детской кардиореанимации
Nelya Bissenova 1
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1 Department of Microbiology, JSC National Scientific Medical Research Center, Astana, Kazakhstan
J CLIN MED KAZ, Volume 2, Issue 44, pp. 27-32.
https://doi.org/10.23950/1812-2892-JCMK-00382
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ABSTRACT
Objective: to report the antibiotic resistance rate of most frequently pathogens in pediatric cardiac intensive care unit (PCICU) during a fve-year period.
Methods. A prospective study was performed on 4228 clinical samples (bloodstream, wound samples, respiratory tract, tracheobronchial tree, and central venous catheter) from patients in PCICU during the period 2012-2016. Identifcation of isolates and antibiotic susceptibility testing were performed by Vitek 2 automated system.
Results. The percentages of most frequently isolated microorganisms in our PCICU were as follows: Klebsiella pneumoniae 8.9%, Pseudomonas aeruginosa 7.5%, Staphylococcus aureus 6.9%, coagulase negative staphylococci 5.3%, and Candida sp. 3.4%. During study period there is tendency increasing the percentage of detection Ps.aeruginosa from 2.6% to 10.8% (p=0.018), K.pneumoniae from 2.6% to 10.5% (p=0.023), and Candida sp. from 1.6% to 5.9% (p=0.033). These isolates showed tendency of signifcant increasing resistance to 3rd generation cephalosporins and carbapenems.
Conclusion. The present study reported that most frequent isolates in our PCICU were Ps.aeruginosa and K.pneumoniae. Reporting of dramatically increasing resistance rates of these isolates necessitates a well-designed hospital infection control strategy, including good hygiene, microbiological monitoring; all of this will greatly reduce the risk of nosocomial infection.
REFERENCES
- Brown PP, Kugelmass AD, Cohen DJ, Reynolds MR, Culler SD, Dee AD, Simon AW. The frequency and cost of complications associated with coronary artery bypass grafting surgery: results from the United States Medicare program. The Annals of thoracic surgery. 2008; 85(6):1980-6.
- Valera M, Scolfaro C, Cappello N, Gramaglia E, Grassitelli S, Abbate MT, Rizzo A, Abbruzzese P, Valori A, Longo S, Tovo PA. Nosocomial infections in pediatric cardiac surgery, Italy. Infection Control & Hospital Epidemiology. 2001; 22(12):771-5.
- Vida VL, Leon-Wyss J, Larrazabal A, Cruz S, Castaňeda AR. Mediastinitis in Pediatric Cardiac Surgery. Pediatric cardiology. 2007; 28(3):163-6.
- Holzmann-Pazgal G, Hopkins-Broyles D, Recktenwald A, Hohrein M, Kieffer P, Huddleston C, Anshuman S, Fraser V. Casecontrol study of pediatric cardiothoracic surgical site infections. Infection Control & Hospital Epidemiology. 2008; 29(1):76-9.
- Mehta PA, Cunningham CK, Colella CB, Alferis G, Weiner LB. Risk factors for sternal wound and other infections in pediatric cardiac surgery patients. The Pediatric infectious disease journal. 2000; 19(10):1000-4.
- Becerra MR, Tantaleán JA, Suárez VJ, Alvarado MC, Candela JL, Urcia FC. Epidemiologic surveillance of nosocomial infections in a Pediatric Intensive Care Unit of a developing country. BMC pediatrics. 2010;10(1):66.
- Singhi S, Rao DS, Chakrabarti A. Candida colonization and candidemia in a pediatric intensive care unit. Pediatr Crit Care Med. 2008; 9:91-95.
- Jefferies JM, Cooper T, Yam T, Clarke SC. Pseudomonas aeruginosa outbreaks in the neonatal intensive care unit – a systematic review of risk factors and environmental sources. J Med Microbiol. 2012; 61:1052-1061.
- Urrea M, Pons M, Serra M, Latorre C, Palomeque A. Prospective incidence study of nosocomial infections in a pediatric intensive care unit. Pediatr Infect Dis J. 2003; 22:490-494.
- Grohskopf LA, Sinkowitz-Cochran RL, Garrett DO, Sohn AH, Levine GL, Siegel JD, et al. Pediatric Prevention Network. A national point-prevalence survey of pediatric intensive care unit-acquired infections in the United States. J Pediatr. 2002; 140:432- 438.
- Stover BH, Shulman ST, Bratcher DF, Brady MT, Levine GL, Jarvis WR. Pediatric Prevention Network. Nosocomial infection rates in US children’s hospitals’ neonatal and pediatric intensive care units. Am J Infect Control. 2001; 29:152-157.
- Barker GM, O’Brien SM, Welke KF, Jacobs ML, Jacobs JP, Benjamin DK, Peterson ED, Jaggers J, Li JS. Major infection after pediatric cardiac surgery: at risk estimation model. Ann Thorac Surg. 2010; 89(3):843–850.
- Almuneef MA, Memish ZA, Balkhy HH, Hijazi O, Cunningham G, et al. Rate, risk factors and outcomes of catheter-related bloodstream infection in a pediatric intensive care unit in Saudi Arabia. J Hosp Infect. 2006; 62:207-213.
- Guidelines of standards for microbiologic tests in the laboratory of clinical microbiology. Astana. 2008; 11-12
- Porto JP, Mantese OC, Arantes A, Freitas C, GontijoFilho PP, et al. Nosocomial infections in a pediatric intensive care unit of a developing country: NHSN surveillance. Rev Soc Bras Med Trop. 2012; 45:475-479.
- Becerra MR, Tantaleán JA, Suárez VJ, Alvarado MC, Candela JL, et al. Epidemiologic surveillance of nosocomial infections in a Pediatric Intensive Care Unit of a developing country. BMC Pediatr. 2010; 10:66-72.
- Grisaru-Soen G, Sweed Y, Lerner-Geva L, Hirsh-Yechezkel G, Boyko V, Vardi A, Keller N, Barzilay Z, Paret G. Nosocomial bloodstream infections in a pediatric intensive care unit: 3-year survey. Medical science monitor. 2007; 13(6):CR251-7.
- Lodha R1, Natchu UC, Nanda M, Kabra SK Nosocomial infections in pediatric intensive care units. Indian J Pediatr. 2001; 68(11):1063-1070.
- Ning BT, Zhang CM, Liu T, Ye S, Yang ZH, Chen ZJ. Pathogenic analysis of sputum from ventilator-associated pneumonia in a pediatric intensive care unit. Experimental and therapeutic medicine. 2013; 5(1):367-71.
- Pfaller MA, Diekema DJ, Jones RN, Sader HS, Fluit AC, Hollis RJ, et al. SENTRY Participant Group. International surveillance of bloodstream infections due to Candida species: Frequency of occurrence and in vitro susceptibilities to fluconazole, ravuconazole, and voriconazole of isolates collected from 1997 through 1999 in the SENTRY antimicrobial surveillance program. J Clin Microbiol. 2001; 39:3254–3259.
- Zaoutis TE, Coffin SE, Chu JH, Heydon K, Zhao H, Greves HM, Walsh TJ. Risk factors for mortality in children with candidemia. The Pediatric infectious disease journal. 2005; 24(8):736-9.
- Marodi L, Johnston Jr RB. Invasive Candida species disease in infants and children: occurrence, risk factors, management, and innate host defense mechanisms. Current opinion in pediatrics. 2007; 19(6):693-7.
- Chow JK, Golan Y, Ruthazer R, Karchmer AW, Carmeli Y, Lichtenberg DA, Chawla V, Young JA, Hadley S. Risk factors for albicans and non-albicans candidemia in the intensive care unit. Critical care medicine. 2008; 36(7):1993-8.
- Garcia-San Miguel L, Cobo J, Martos I, Otheo E, Muriel A, Pintado V, Moreno S. Risk factors for candidemia in pediatric patients with congenital heart disease. Infection Control & Hospital Epidemiology. 2006;27(6):576-80.
- Alotaibi MG, Rahman S, Al-Shalaan MA, Omair A. Frequency of Nosocomial Infections in Pediatric Intensive Care Unit at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Journal of Infectious Diseases & Therapy. 2015; 3(5):234-237.
- Jaballah NB, Bouziri A, Mnif K, Hamdi A, Khaldi A, Kchaou W. Epidemiology of hospital-acquired bloodstream infections in a Tunisian pediatric intensive care unit: a 2-year prospective study. American journal of infection control. 2007; 35(9):613-8
- Koleff MH. The prevention of ventilator associated pneumonia. NEJM. 1999; 340:627-641.
- Carvalho CE, Berezin EN, Pistelli IP, Mímica L, Cardoso MR. Sequential microbiological monitoring of tracheal aspirates in intubated patients admitted to a pediatric intensive care unit. J Pediatr. 2005; 81(1):234-240.
- Mammina C, Carlo PD, Cipolla D, Casuccio A, Tantillo M, Plano MR, Mazzola A, Corsello G. Nosocomial colonization due to imipenem-resistant Pseudomonas aeruginosa epidemiologically linked to breast milk feeding in a neonatal intensive care unit. Acta Pharmacologica Sinica. 2008; 29:1486–1492 .
- Lee CY, Chen PY, Huang FL, Lin CF. Microbiologic spectrum and susceptibility pattern of clinical isolates from the pediatric intensive care unit in a single medical center — 6 years’ experience. J Microbiol Immunol Infect. 2009; 42:160-165.
- Wang LJ, Sun Y, Song WL, Zhang ZJ, Liu CF. Changes of drug-resistance of Pseudomonas aeruginosa in pediatric intensive care unit. Chinese J of Pediatr. 2012; 50(9):657-663.