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Revista Brasileira de Terapia Intensiva

Print version ISSN 0103-507X

Abstract

SILVA, Andre Ricardo Araujo da; SIMOES, Maria Luiza Costa de Lima; WERNECK, Lucia dos Santos  and  TEIXEIRA, Cristiane Henriques. Healthcare associated infections caused by coagulase-negative Staphylococci in a neonatal intensive care unit. Rev. bras. ter. intensiva [online]. 2013, vol.25, n.3, pp.239-244. ISSN 0103-507X.  https://doi.org/10.5935/0103-507X.20130041.

OBJECTIVE:

This study sought to evaluate infections related to health care caused by coagulase-negative Staphylococci in a neonatal intensive care unit by assessing antimicrobial susceptibility profiles and potentially effective antibiotic regimens.

METHODS:

This was a retrospective descriptive study performed on a case series of healthcare-associated infections, and the antimicrobial susceptibility profiles were evaluated. Newborns from other hospitals who were admitted to a neonatal intensive care unit in Rio de Janeiro between January 1, 2010, and June 30, 2012, were studied.

RESULTS:

In total, 765 patients were admitted, totaling 3,051 patient-days, and the incidence density of general infection was 18.9 per 1,000 patient-days. The rate of central venous catheter use was 71.6%, and the positive culture rate for all sites and all infections related to health care were 68.4%. Coagulase-negative Staphylococci were identified in 11 (19.2%) of 57 health care-related infections, and infections with extended-spectrum beta-lactamase producing Klebsiella pneumoniae and Candida sp. constituted 5 cases each. Of the 11 cases of coagulase-negative Staphylococci, 10 (90.9%) were primary bloodstream infections. The sensitivity of the coagulase-negative Staphylococci isolates to vancomycin, clindamycin, ciprofloxacin, oxacillin and gentamycin was 100%, 81.8%, 72.7%, 27.2% and 22.2%, respectively. There were no deaths directly attributed to coagulase-negative Staphylococci infection.

CONCLUSION:

Coagulase-negative Staphylococci was the main agent identified in healthcare-associated infections, with low rates of infections related to central venous catheter. In hospitals with a high oxacillin resistance profile, similar to those included in this study, vancomycin may be used as an initial therapy, although clindamycin represents a viable alternative.

Keywords : Cross-infection; Intensive care, neonatal; Staphylococcus.

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