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Epidemiology of Blood-Stream Infection in Portuguese Neonatal Intensive Care Units

Principal investigators – Maria Teresa Neto, Alexandra Almeida
Co-investigators: Almerinda Pereira, Ana Lúcia Maia, Cristina Resende, Ermelinda Mendes, Eunice Soares, Olga Voutsen, Margarida Cabral, Luísa Malheiro, Anabela João, Mónica Marçal, Susana Pissarra, Margarida Abrantes, Mª José Mendes, Edite Costa, Teresa Cezanne, Teresa Caldeira.

Nova Medical School /FCM/UNL. Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Lisboa; Centro Médico Hospitalar do Norte. Departamento da Qualidade em Saúde, Direcção Geral de Saúde. Department of Quality in Health. Directorate General of Health. Lisbon, Portugal

Jornadas Nacionais de Neonatologia. Comunicação oral

Objective - To know the epidemiology of bloodstream infection in newborn infants admitted to Portuguese NICUs.
Methods – All patients in the National Registry, admitted from January 2008 to December 2015, with sepsis, meningitis, necrotising enterocolitis and pneumonia with positive blood or cerebrospinal fluid cultures were enrolled.
Results – There were 40 205 registrations with 2906 positive cultures in 2352 newborn infants accounting for 2593 episodes of infection and 10.9 episodes of infection /1000 admission days. The median of GA and BW were 30 weeks(22-42) and 1300g(416-5270); 55.2% were male; 2273 episodes were sepsis, 121 sepsis with meningitis, 103 necrotising enterocolitis with sepsis, 95 sepsis with pneumonia and 1 sepsis with meningitis and pneumonia; 433 (16.7%) episodes were classified as early-onset, 1742 (67.2%) as late-onset and 418 as post-neonatal infections. There were 141 deaths caused by infection - lethality 6%. Five cultures grew two different strains – total of strains 2598. The most frequent isolates were coagulase negative Staphylococcus(91.2% resistant to methicillin, 81.4% resistant to gentamicin); S. aureus(25.3% resistant to methicillin); E.coli(68.9% resistant to ampicillin); group B Streptococcus; Klebsiella spp(44.4% and 33,3 resistant respectively to cefotaxime and to gentamicin); 41% of Enterobacter spp were resistant to cefotaxime; 1551 episodes of infection occurred in newborn infants with a central venous catheter (CVC) - rate of infection in patients with CVC 10.4/1000 CVC days.
Comments - Findings are in the range of what could be expected; bacterial resistance is a cause of concern as well as the rate of infection in newborn infants with CVC.

Palavras-Chave: Bloodstream infection, microorganisms, newborn infants, NICU