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[The Age of Multidrug Resistance: Ten Year Incidence in a Neonatal Intensive Care Unit]

Bruno Sanches1, Rita Guerreiro1, José Diogo2

  • 1Unidade de Cuidados Intensivos Neonatais. Serviço de Pediatria. Hospital Garcia de Orta. Almada. Portugal.

Acta Medica Portuguesa
|March 5, 2020
PubMed
Abstract

Insights

Multidrug-resistant bacterial infections are a significant concern in neonatal intensive care units. This study found a 3.2 episodes/100 hospitalizations incidence rate, with Enterobacteriaceae being the most common pathogen.

Area of Science:

  • Neonatal Intensive Care Unit (NICU) infections
  • Infectious disease epidemiology
  • Bacterial resistance

Background:

  • Multidrug-resistant bacteria (MDRB) pose a growing global health threat.
  • Neonatal intensive care units are particularly vulnerable to MDRB outbreaks.
  • Understanding the incidence and patterns of MDRB is crucial for effective control.

Purpose of the Study:

  • To determine the incidence of multidrug-resistant bacterial infections in a neonatal Intensive Care Unit.
  • To identify common MDRB pathogens and associated risk factors.
  • To assess the impact and lethality of these infections.

Main Methods:

  • A retrospective, descriptive incidence study was conducted.
  • Data were collected over a 10-year period (2008-2017) in a specialized perinatal support unit.
  • Infectious episodes, causative agents, risk factors, and outcomes were analyzed.

Main Results:

  • Sixty-four infectious episodes were identified, with a median gestational age of 28 weeks and birth weight of 885g.
  • Enterobacteriaceae (46 episodes) were the predominant pathogens, followed by Methicillin-resistant Staphylococcus aureus (12 episodes).
  • Central catheter use (89%) and prior antibiotic therapy (78%) were significant risk factors. The infection lethality rate was 10.9%.

Conclusions:

  • The incidence rate of 3.2 episodes/100 hospitalizations highlights the significant burden of MDRB in this high-risk NICU population.
  • The predominance of Enterobacteriaceae aligns with global trends in antimicrobial resistance.
  • Three infectious outbreaks underscore the need for enhanced infection control measures and understanding local dissemination patterns.
Keywords:
Drug Resistance, Multiple, BacterialInfant, NewbornIntensive Care Units, NeonatalPortugal

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