Caracterização epidemiológica das infecções primárias de corrente sanguínea por staphylococcus coagulase-negativa em unidades de terapia intensiva neonatal

Abstract

Introduction: coagulase-negative Staphylococcus is recognized as the main pathogen involved in sepsis on neonatal period, and Staphylococcus epidermidis the most frequent. Objective: To describe the epidemiology of newborns affected by primary bloodstream infection caused by coagulase-negative Staphylococcus in neonatal intensive care units. Methods: Cross-sectional, retrospective study performed in the neonatal intensive care unit (NICU) of the Moinhos de Vento Hospital and São Lucas Hospital from January 2011 to December 2013. The data were collected prospectively by Hospital Infection Control Service both institutions and held records consulted by researchers when necessary. Results: All primary bloodstream infections caused by coagulase-negative Staphylococcus (n = 99) were included. It more frequent in boys, patients with gestational age <32 weeks and those who used parenteral nutrition, peripherally inserted central catheter and mechanical ventilation. The five weight groups are heterogeneous. It was found that 49.5% of infections are caused by Staphylococcus epidermidis. Bloating, down saturation, apnea and the need for increased supply of oxygen were the most frequent symptoms in infants less than 30 weeks of gestational age and birth weight less than 1003 grams; underactive, vomiting and fever occurred in babies with appropriate weight and gestational age. The antimicrobial treatment regimen was used over monotherapy with vancomycin, vancomycin and amikacin followed by association. The most common outcome in this population was hospital discharge. Conclusion: As in other studies, Staphylococcus epidermidis was the most common organism identified in this population. The use of invasive devices must be questioned daily with the aim of early withdrawal. The medical-care team of the NICU should be engaged in preventing these infections in order to ensure safety and quality of care / treatment of newborns.