Andre Ricardo Araujo Da Silva
Federal Fluminense University, Brazil
Title: Increase of gram negative multi resistance in cases of HAI in a PICU of reference
Biography
Biography: Andre Ricardo Araujo Da Silva
Abstract
Multidrug-resistance is a global concern. This is a major problem within intensive care units (ICU), where usually doctors have few options to treat healthcare associated infections (HAI). The aim of our work is to describe profile of Gram-negative resistance in cases of HAI occurred in a Pediatric Intensive Care Unit (PICU) of reference. We did a prospective study of all HAI reported in PICU of Prontobaby-Children’s Hospital, with focus in infections due to Gram-negative bacteria. We used National Healthcare Safety Network (NHSN) criteria to define HAI. Gram-negative resistance was defined according Magiorakis criteria. In seven-years of follow-up (from January 2009 to December 2015), we reported 224 HAI. 65 cases were due to Gram-negative and global rates of resistance reported were 47.7%. HAI rates ranges from 9.4 to 15.1 per 1000 patient-days in PICU, during the study. In five of seven years, Gram-negative resistance was higher than 50%. During this period only two HAI due to Enterobacteriaceae resistant to carbapenem were reported (0.9% of all HAI). The main agents founded are Enterobacteriaceae ESBL producers and P. aeruginosa resistant to carbapenem. In our casuistic, we found higher rates of Gram-negative bacterial resistance in cases of HAI. To avoid this problem, it is necessary to develop strategies to reduce incidence of HAI, even in critical ill children. Also, new treatment options are urgently needed.