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[Nosocomial infection caused by multiresistant Staphylococci in a neonatal and pediatric intensive care unit]
P Tuo1, G Montobbio, R Vallarino
1Unità di Terapia Intensiva Neonatale e Pediatrica-Istituto G. Gaslini di Genova, Italia.
Insights
Nosocomial infections in paediatric intensive care units (ICUs) significantly increased between 1987-1988 and 1992, particularly in neonates. This rise was driven by multiresistant Staphylococcus haemolyticus and new gram-negative germs.
Area of Science:
- Infectious Diseases
- Paediatric Critical Care
Context:
- A paediatric intensive care unit (ICU) population was studied over two periods (1987-1988 and 1992).
- Both study periods involved paediatric patients with similar high-risk factors for nosocomial infections.
- High-risk factors included mechanical ventilation, intubation, and surgical procedures.
Purpose:
- To evaluate changes in colonization and ICU-specific nosocomial infection incidence.
- To assess the increase in infections caused by multiresistant Staphylococci.
- To identify the emergence of new multiresistant pathogens.
Summary:
- Colonization rates remained stable, but ICU-specific nosocomial infections significantly increased from 4.9% to 10.3% (p > 0.0014).
- The neonatal population experienced a disproportionate rise in infections, from 7% to 18.9% (p > 0.00001).
- Infections caused by multiresistant Staphylococcus haemolyticus, showing resistance to teicoplanin, significantly increased, alongside the presence of multiresistant gram-negative germs.
Impact:
- Highlights a significant increase in paediatric ICU nosocomial infections, especially in neonates.
- Identifies specific pathogens, including teicoplanin-resistant Staphylococcus haemolyticus, contributing to this rise.
- Underscores the emergence of new multiresistant gram-negative organisms, posing a growing threat in paediatric critical care settings.
Abstract:
We selected a paediatric population with a high risk of nosocomial infection formed by 116 newborns (42.8%) and 155 not newborns (57.2%) admitted into the ICU of the Giannina Gaslini Institute during the period 1-1-1992-30-9-1992; we compared it with a reference paediatric population studied in the same department during the period 1-1-1987-30-6-1988 formed by 310 newborns (44.3%) and 391 not newborns (55.7%). The purpose of this study is to evaluate the possible change in the incidence of colonizations and ICU specific nosocomial infections, the possible increase of nosocomial infections by multiresistant Staphylococci and the appearance of new multiresistant germs. The two populations obviously present similar factors of high risk of nosocomial infection (naso-tracheal intubation, mechanical ventilation, total parenteral nutrition, surgical procedures, thoracic and/or abdominal prothesis, etc.). The obtained data have been examined with the Chi-square method. The incidence of colonizations remained unchanged while we noted a significant increase (10.3% compared to 4.9%-p > 0.0014) of the "ICU" specific nosocomial infections; the increase regarded mainly the neonatal population (18.9% compared to 7%-p > 0.00001). Significant increase of the nosocomial infections by multiresistant Staphylococcus (Staphylococcus haemolyticus) with in vitro and in vivo resistance to teicoplanin. Furthermore, presence in the performed study of multiresistant gram negative germs.