Analysis of pathogens of hospital-acquired infections in the pediatric department of intensive care
DOI:
https://doi.org/10.15574/SP.2024.8(144).8994Keywords:
antibiotic resistance, nosocomial infections, gram-negative microorganisms, gram-positive microorganisms, pathogens, childrenAbstract
The problem of nosocomial infections and antibiotic resistance has acquired particular relevance and has medical, socio-economic importance.
Aim - to investigate the microorganism spectrum and prevalence of nosocomial infections (NI) pathogens in the pediatric intensive care unit (PICU) and to determine the association between NI and mortality in PICUs patients.
Materials and methods. A retrospective analysis of 101 case histories of children aged (1 month - 18 years) of the PICU of hospital N from 2019 to 2021. Strains from various loci were studied (sputum, swabs from the throat and nose, blood, urine, feces, cerebrospinal fluid (CSF), pleural fluid, central venous catheter (CVC), culture from a wound, navel, ear, secretions of scrotum) were studied. Microorganisms were identified by traditional methods on the basis of their morphologic, cultural, and biochemical properties. According to international diagnostic standards, 49 patients among 101 hospitalized ones were diagnosed with NI. The research results were statistically analyzed using the Microsoft Excel 2010 spreadsheet program and IBM SPSS Statistic version 22.
Results. Ps. aeruginosa was identified significantly more often than Kl. pneumonia - 39.9% (n=153) of patients compared with 27.7% (n=106). Patients with NI are 1.6 times more likely to be infected with Ps. aeruginosa than Kl. pneumonia. Kl. pneumonia infection was significantly more frequent in patients than Candida alb. - 27.7% (n=106) compared with 13.6% (n=52). However, infection with Candida alb. was significantly more common than Methicillin-resistant Staphylococcus aureus (MRSA) - 13.6% (n=52) compared with 6.5% (n=25). Patients with NI are twice as likely to be infected with Candida alb. than MRSA. Fatal cases were found significantly more often in 18.4% (n=9) of patients with NI.
Conclusions. Gram-negative microorganisms prevailed 26 times in the examined patients with HIV from different locales - 70.5% (n=270) of samples to gram-positive - 13.3% (n=53). The prevalence of Ps. aeruginosa, Kl. pneumonia and Candida alb. was significantly higher than in European countries
The research was conducted in accordance with the principles of the Declaration of the Helsinki. The research protocol was approved by the ethics committee for all participants. Parents’ informed consent was obtained for the research.
The authors declare no conflict of interest.
References
Bogue TL, Bogue RL. (2017). Unbundling the Bundles: Using Apparent and Systemic Cause Analysis to Prevent Health Care-Associated Infection in Pediatric Intensive Care Units. Critical care nursing clinics of North America. 29(2): 217-231. https://doi.org/10.1016/j.cnc.2017.01.008; PMid:28460702
Branstetter JW, Barker L, Yarbrough A, Ross S, Stultz JS. (2021). Challenges of Antibiotic Stewardship in the Pediatric and Neonatal Intensive Care Units. The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG. 26(7): 659-668. https://doi.org/10.5863/1551-6776-26.7.659; PMid:34588929 PMCid:PMC8475799
Cerini P, Meduri FR, Tomassetti F, Polidori I, Brugneti M, Nicolai E et al. (2023). Trends in Antibiotic Resistance of Nosocomial and Community-Acquired Infections in Italy. Antibiotics. 12: 651. https://doi.org/10.3390/antibiotics12040651; PMid:37107013 PMCid:PMC10135155
Elnasser Z, Obeidat H, Amarin Z. (2021). Device-related infections in a pediatric intensive care unit: The Jordan University of Science and Technology experience. Medicine. 100(43): e27651. https://doi.org/10.1097/MD.0000000000027651; PMid:34713857 PMCid:PMC8556052
Joram N, de Saint Blanquat L, Stamm D, Launay E, Gras-Le Guen C. (2012). Healthcare-associated infection prevention in pediatric intensive care units: a review. European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology. 31(10): 2481-2490. https://doi.org/10.1007/s10096-012-1611-0; PMid:22466969
Loaiza WM, Ruiz AKR, Patiño CCO, Vivas MC. (2023). Bacterial Resistance in Hospital-Acquired Infections Acquired in the Intensive Care Unit: A Systematic Review. Acta medica (Hradec Kralove). 66(1): 1-10. https://doi.org/10.14712/18059694.2023.8; PMid:37384803
McGrath EJ, Asmar BI. (2011). Nosocomial infections and multidrug-resistant bacterial organisms in the pediatric intensive care unit. Indian journal of pediatrics. 78(2): 176-184. https://doi.org/10.1007/s12098-010-0253-4; PMid:20936380
MOZ Ukrainy. (2021). Pro zatverdzhennia Poriadku zdiisnennia dozornoho epidemiolohichnoho nahliadu za protymikrobnoiu rezystentnistiu. Nakaz MOZ Ukrainy vid 19.08.2021 No.1766.
MOZ Ukrainy. (2021). Pro zatverdzhennia Zminy do Kryteriiv, za yakymy vyznachaiutsia vypadky infektsiinykh ta parazytarnykh zakhvoriuvan, yaki pidliahaiut reiestratsii. Nakaz MOZ Ukrainy vid 15.07.2021 No.1447.
Nimer NA. (2022). Nosocomial Infection and Antibiotic-Resistant Threat in the Middle East. Infect Drug Resist. 15: 631-639. URL: https://pubmed.ncbi.nlm.nih.gov/35241915/. https://doi.org/10.2147/IDR.S351755; PMid:35241915 PMCid:PMC8887909
O'Neill J. (2014). Antimicrobial resistance: tackling a crisis for the health and wealth of nations. The Review on Antimicrobial Resistance. 20: 1-16. URL: https://amr-review.org/sites/default/files/AMR%20Review%20Paper%20%20Tackling%20a%20crisis%20for%20the%20health%20and%20wealth%20of%20nations_1.pdf
Petrosillo N, Capone A, Di Bella S, Taglietti F. (2010). Management of antibiotic resistance in the intensive care unit setting. Expert review of anti-infective therapy. 8(3): 289-302. https://doi.org/10.1586/eri.10.7; PMid:20192683
Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD et al. (2009). International study of the prevalence and outcomes of infection in intensive care units. JAMA. 302(21): 2323-2329. https://doi.org/10.1001/jama.2009.1754; PMid:19952319
Zingg W, Hopkins S, Gayet-Ageron A, Holmes A, Sharland M, Suetens C et al. (2017). Health-care-associated infections in neonates, children, and adolescents: an analysis of paediatric data from the European Centre for Disease Prevention and Control point-prevalence survey. The Lancet. Infectious diseases. 17(4): 381-389. https://doi.org/10.1016/S1473-3099(16)30517-5; PMid:28089444
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