Abstract Neonatal sepsis continues to be a major cause of morbidity and mortality worldwide. Coagulase-negative staphylococci (CoNS), commonly found on the skin, being the main agents isolated. The aim of this study was to evaluate CoNS isolated from blood cultures of newborn (NB) infants. The study took place between 2014 and 2016/2017 in a tertiary hospital in southern Brazil. Using the VITEK 2 system (bioMérieux, Marcy l'Etoile, France), the microorganisms were identified and had their sensitivity profiles determined. The minimum inhibitory concentrations of linezolid, tigecycline, and vancomycin were also determined. The clinical parameters and mortality rates of NBs were evaluated. From January to December 2014, 176 CoNS isolates were obtained from 131 patients and from June 2016 to July 2017, 120 CoNS isolates were obtained from 79 patients. Staphylococcus epidermidis was most prevalent in both periods. Resistance rates increased between 2014 and 2016/2017, especially against ciprofloxacin (52.27% and 73.11%, p = 0.0004), erythromycin (51.40% and 68.07%, p = 0.0054), gentamicin (50.59% and 67.23%, p = 0.0052), and penicillin (71.3% and 99.17%, p = 0.0001), respectively. With 100% susceptibility to linezolid, tigecycline, and vancomycin in both periods and methodologies tested. In 2014, 53.44% of the NBs received antibiotic therapy, and of these, 77.14% used a catheter; in 2016/2017, these were 78.48% and 95.16%, respectively. Regarding laboratory tests, a hemogram was ineffective, since patients with sepsis presented normal reference values. In 2014 and 2016/17, 15.71% and 17.74% of the NBs died, respectively. S. epidermidis was the predominant microorganism, related to catheter use in most cases. The resistance rates have increased over time, demonstrating the importance of adopting control and prevention measures in this hospital. CoNS are responsible for a significant neonatal sepsis mortality rate in infants.

Abstract INTRODUCTION: Coagulase-negative staphylococci (CoNS) are a frequent cause of bacteremia, especially in neonates. The major virulence determinant in CoNS is the ability to produce biofilms, which is conferred by the icaADBC genes. This study aimed to assess different methods for the detection of biofilm formation in 176 CoNS isolates from blood cultures of newborns. METHODS: The presence of the icaACD genes was assessed by polymerase chain reaction (PCR), and biofilm formation was assessed on congo red agar (CRA), by the tube method (TM), and on tissue culture plates (TCP). RESULTS: Of the 176 CoNS isolates, 30.1% expressed icaACD and 11.4% expressed icaAD. The CRA assay and TM showed that 42% and 38.6% of the isolates were biofilm producing, respectively. On TCP, 40.9% of the isolates produced biofilms; 21% were weakly adherent and 19.9% were strongly adherent. When compared to the gold standard technique (PCR), the CRAassay showed 79% sensitivity and 84% specificity (kappa = 0.64), TM showed 78% sensitivity and 89% specificity (kappa = 0.68), and TCP showed 99% sensitivity and 100% specificity (kappa = 0.99). CONCLUSIONS: In this study, ~42% of CoNS isolates produced biofilms, and the presence of icaACD was associated with a greater capacity to form biofilms. Compared to the other phenotypic methodologies, TCP is an ideal procedure for routine laboratory use.

OBJETIVO: pesquisar, entre um grupo de fonoaudiólogos, o grau de conhecimento e utilização das normas de biossegurança na rotina clínica. MÉTODO: foi realizada pesquisa por meio de um questionário respondido por cem profissionais de diferentes áreas de atuação (Audiologia Clínica, Audiologia Ocupacional, Voz, Neonatologia, Linguagem, Motricidade Orofacial e que atuam em mais de uma área). Cada item, respondido de forma positiva, correspondia a 1 ou 2 pontos, sendo a máxima pontuação (100%) correspondendo a 80 pontos. As respostas obtidas foram analisadas e as pontuações encontradas, padronizadas, ou seja, transformadas em índices percentuais indicando seu desempenho. O valor da percentagem de cada questionário poderia variar de 0 a 100%, sendo que quanto maior a percentagem obtida, maior o conhecimento e aplicabilidade das normas de biossegurança pelo profissional na rotina clínica. Foram adotadas as faixas de (0-25%), (26-50%), (51-75%) e (76-100%) para distinguir o nível de conhecimento e aplicação das medidas de precaução pelos participantes. RESULTADOS: dos cem fonoaudiólogos avaliados por meio dos questionários (100%), 1% obteve a percentagem na faixa de (0 a 25%), 45% em (26 a 50%), 50% entre (51 a 75%) e 4% (76 a 100%). CONCLUSÃO: a maioria dos profissionais que participaram conhece e aplica as medidas de biossegurança.

PURPOSE: research, among a group of speech pathologists, the degree of knowledge and use of standards of biosafety in clinical routine. METHOD: a survey was conducted through a questionnaire answered by one hundred professionals from different areas (Clinical Audiology, Occupational Audiology, Voice, Neonatology, Language, Orofacial Motricity and more than one performing area). Each item, responded in a positive way, corresponding to 1 or 2 points and the maximum score (100%) corresponding to 80 points. The responses were analyzed and the found scores were standardized, or converted into percentage index indicating its performance. The percentage value of each questionnaire could vary from 0 to 100%, and the greater the percentage obtained, the more knowledge and applicability of standards of biosafety professionals in the clinical routine. Tracks were taken (0-25%), (26-50%), (51-75%) and (76-100%) to distinguish the level of knowledge and application of precautionary measures by the participants. RESULTS: of one hundred speech therapists assessed by the questionnaires (100%), 1% obtained the percentage in the range (0 to 25%), 45% (26 to 50%), between 50% (51 to 75%) and 4% (76 to 100%). CONCLUSION: the most of the professionals who participated knows and applies biosafety measures.