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Endo-Tracheal Tube Associated Bacterial Infection, Prevalence and their Drug Susceptibility Pattern in NICU


Affiliations
1 Dept of Pediatrics, Zhongnan Hospital of Wuhan University, China
2 Dept of General Surgery, Zhongnan Hospital of Wuhan University, China
3 Dept of Endocrinology, Zhongnan Hospital of Wuhan University, China
 

Aim of this article is to provide an overview of modifiable and nonmodifiable factor in the development of Nosocomial Infections (NIs) in the Neonatal Intensive Care Units (NICUs).Endotracheal tube intubation/Mechanical ventilation is a lifesaving invasive procedure which is associated with their own potential complications, like ventilator associated pneumonia (VAP), sepsis, Ventilator associated-tracheo-bronchitis(VAT), acute respiratory distress syndrome, pulmonary embolism, Barotrauma and pulmonary edema, which can occur among the patients receiving mechanical ventilation. Among the above listed complication, Neonatal sepsis is the most common and VAP is the second most common encountered Nosocomial infection, which account for the most of the morbidity and mortality in the NICUs and ventilated patients. PubMed, Embase and google scholar have been searched for the articles meeting our criteria,total fourteen articles have been used. Neither any alterations or modifications nor any Software's were used in this article. In some recent research article and literature, some strategy have been mentioned, which are resulting in better control of Nosocomial infection due to ventilator or endotracheal tube intubation. Gram-negative bacteria are most prevalent in the developing countries and Gram-positive in the developed countries, Klebsiella pneumonia, E. coli and staphylococcus aureus are the most common reason for NIs. Increasing number of NIs and multidrug resistance bacteria are matter of concern for Neonatologist around the world.

Keywords

Nosocomial Infection in NICUs, VAP, VAT, Bacterial Prevalence, Antimicrobial Susceptibility.
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  • Sadowska-Krawczenko I, Jankowska A, Kurylak A. Healthcare-associated infections in a neonatal intensive care unit. Arch Med Sci 2012;8(5):854-8.

  • Haque KN, Chagia AH, Shaheed MM. Half a Decade of Neonatal Sepsis, Riyadh, Saudi Arabia. J Trop Pedia 1990; 36(1):20-3.

  • Brady MT. Health care-associated infections in the neonatal intensive care unit. Am J Infect Control 2005;33:268–75.

  • Auriti C, Maccalini A, Di Liso G. Risk factors for nosocomial infections in a neonatal intensive-care unit. J Hosp Infect 2003;53:25–30.

  • Tavora AC, Castro AB, Militao MA, Girao JE, Ribeiro KB, Tavora LG. Risk factors for nosocomial infection in a Brazilian neonatal intensive care unit. Braz J Infect Dis 2008;12(1):75-9.

  • Niederman MS, Craven DE, Bonten MJ. American Thoracic Soci and Infect Dise Soci of America (ATS/IDSA). Guideline for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005; 171:388–416.

  • Chastre J, Fagon JY. Ventilatorassociated pneumonia. Am J Respir Crit Care Med 2002;165:867–903.

  • Cook DJ, Kollef MH. Risk factors for ICUacquired pneumonia. JAMA 1998; 279:1605-6.

  • Nseir S, Di Pompeo C, Pronnier P. Nosocomial tracheobronchitis in mechanically ventilated patients: incidence, aetiology and outcome. Eur Respir J 2002;20:1483–9.

  • Nseir S, Favory R, Jozefowicz E, Antimicrobial treatment for Ventilatorassociated tracheobronchitis: a randomized controlled multicenter study. Crit Care 2008;12:R62.

  • Auriti C, Maccallini A, Di Liso G, Di Ciommo V, Ronchetti MP, Orzalesi M. Risk factors for nosocomial infections in a neonatal intensive-care unit. J Hosp Infect 2003;53(1):25-30.

  • Kawagoe JY, Segre CM, Pereira CR, Cardoso MF, Silva CV, Fukushima JT. Risk factors for nosocomial infections in critically ill newborns: a 5-year prospective cohort study. Am J Infect Control 2001;29(2):109-14.

  • Zaid AK, Huskins WC, Thaver D, Bhutta ZA, Abbas Z, Goldmann DA. Hospitalacquired neonatal infections in developing countries. Lancet 2005; 365(9465):1175-88.

  • S Shrestha, N Adhikari, BK Rai, A Shreepaili. Antibiotic resistance pattern of bacterial isolates in neonatal care unit. J of the Nepal Med Asso 20110; 50(4):277-81.

  • Afif Ahmad, Samawal lutfi, Moza Al hail, Muna Al Saadi. Antibiotic susceptibility patterns of microbial isolates from blodd culture in the neonatal intensive care unit. Asian J Pharm Clin Res. 2013;6(S2):191-5.

  • Doaa Mohammed, Omnia S. El Seifi, Bacterial nosocomial infections in neonatal intensive care unit, Zagazig Uni Hosp, Egypt. Egypt Pedia Assoc Gazette 2014;62:72–9.

  • Sally AF El- Sahrigy, Azza MO Abdel Rahman, Hala Youssef, Ahmed A Talaat, Dalia A Khairy, Howayda E Gomaa, et al. Nosocomial Infection in an Egyptian Neonatal Intensive Care Unit. Research J of Pharm, Bio and Chemi Sci 2015; 6(1):346.

  • Mehmet Yalaz, Hasan Çetin, Mete Akisu, Şohret Aydemir, Alper Tunger, Nilgun Kultursay. Neonatal nosocomial sepsis in a level-III NICU: evaluation of the causstive aganets and antimicrobial susceptibilities. The Turkish J of Pedia 2006;48:13-8.

  • Shrestha S, Shrestha NC, Dongol Singh S, Shrestha RPB, Kayestha S, Shrestha M, et al. Bacterial Isolates and its Antibiotic Susceptibility Pattern in NICU. Kathmandu Univ Med J 2013;41(1):6670.

  • Eman M RabieShehab El-Din, Mohamed M. Adel El-Sokkary, Mohamed Reda Bassiouny, Ramadan Hassan. Epidemiology of Neonatal Sepsis and Implicated Pathogens: A Study from Egypt. Bio Med Res Inter07/2015; 2015:1-11.

  • Dal-Bo K, Silva RM, Sakae TM. Nosocomial infections in a neonatal intensive care unit in South Brazil Rev Bras Ter Intensiva 2012;24(4):381-5.

  • Khan MA, Khan A, Shah F, Munir A. Neonatal sepsis: a study of causative pathogens and their antimicrobial sensitivity pattern at tertiary hospital. Gomal J Med Sci 2012;10:244-7.

  • Centers for Disease Control and Prevention: Criteria for defining nosocomial pneumonia. www.cdc.gov /ncidod/hip/NNIS/members/penumonia /Final/PneuCriteriaFinal.pdf

  • Baltimore RS. The difficulty of diagnosing ventilator-associated pneumonia. Pediatrics2003;112:1420–1.

  • Mohamed A Badr, Yasser F Ali, Ehab AM Albanna, Mohamed R Beshir, Gahda E Amr. Ventilator associated pneumonia in critically-II neonates admitted to neonatal intensive care unit. Iranian J of Pedia 2011;21(4):418-24.

  • El-Kholy A, Saied T, Gaber M, Younan MA, Haleim MM, El-Sayed H, et al. Device-associated nosocomial infection rates in intensive care units at Cairo University hospitals: first step toward initiating surveillance programs in a resource-limited country. Am J Infect Control 2012;40:e216–e20.

  • Yuan TM, Chen LH, Yu HM. Risk factors and outcomes for ventilator-associated pneumonia in neonatal intensive care unit patients. J Perinat Med 2007; 35:334–8.

  • Afjeh SA, Sabzehei MK, Karimi A, Shiva F, Shamshiri AR. Surveillance of ventilatorassociated pneumonia in a neonatal intensive care unit: characteristics, risk factors, and outcome. Arch Iran Med 2012;15:567–71.

  • Tripathi SH, Malik GK, Jain A, Kohli N. Study of ventilator associated pneumonia in neonatal intensive care unit: characteristics, risk factors and outcome. Internet J Med Update 2010; 5:12–9.

  • Deng C, Li X, Zou Y. Risk factors and pathogen profile of ventilatorassociated pneumonia in a neonatal intensive care unit in China. Pediatr Int 2011; 53:332–7.

  • Craven DE. Preventing ventilatorassociated pneumonia in adults: sowing seeds of change. Chest 2006;130:251– 60.

  • Stoll BJ, Hansen NI, Sanchez PJ. Early onset neonatal sepsis: the burden of group B streptococcal and E. coli disease continues. Pediatrics 2011;127:87-96.

  • Garland JS. Strategies to prevent ventilator associated pneumonia in neonates. Clin Perinatal 2010;37:629–43.

  • Nagata E, Brito ASJ, Matsuo T. Nosocomial infections in a neonatal intensive care unit: Incidence and risk factors. Am J Infect Control 2002;30:26– 31.

  • Won SP, Chou HC, Hsieh WS, Chen CY, Huang SM, Tsou KL, et al. Handwashing program for the prevention of nosocomial infections in a neonatal intensive care unit. Infect Control Hosp Epide 2004;25:742–6.

  • Needleman J, Buerhaus P, Mattke S, Stewart M, Zelevinsky K. Nurse-staffing levels and the quality of care in hospitals. N Engl J Med 2002;346:171522.

  • Drakulovic MB, Torres A, Bauer TT, Nicolas JM, Nogue S, Ferrer M. Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients: a randomized trial. Lancet 1999;354:1851-8.

  • Weiss M, Dullenkopf A, Fischer JE, Keller C, Gerber AC. Prospective randomized controlled multi-centre trial of cuffed or uncuffed endotracheal tubes in small children. Br J Anaesth2009;103:867–73.

  • Machado MC, Cheng D, Tarquinio KM, Webster TJ. Nanotechnology: pediatric applications. Pediatr Res 2010;67:500–4.

  • Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R. Guidelines for preventing healthcare- associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee MMWR Recomm Rep 2004;53:1–36.

  • Ohlsson A, Lacy JB. Intravenous immunoglobulin for preventing infection in preterm and or low birth weight infants. The Cochrane Library 2013, 7.Art. Art. No.: CD000361. DOI: 10.1002/14651858.CD000361.pub3.

  • Carr R, Modi N, Dore CJ, El-Rifai R, Lindo D. A randomized, controlled trial of prophylactic granulocyte macrophage colony-stimulating factor in human newborns less than 32 weeks gestation. Pediatrics 1999;103:796–802.

  • Morrow LE, Kollef MH, Casale TB. Probiotic prophylaxis of ventilatorassociated pneumonia: a blinded, randomized, controlled trial. Am J Respir Crit Care Med 2010;182:1058-64.

  • Morris AC, Kefala K, Simpson AJ. Evaluation of the effect of diagnostic methodology on the reported incidence of ventilator-associated pneumonia. Thorax 2009;64:516–22.

  • Sachdev A, Chugh K, Sethi M. Diagnosis of ventilator-associated pneumonia in children in resource-limited setting: a comparative study of bronchoscopic and non-bronchoscopic methods. Pediatr Crit Care Med 2010;11:258–66.

  • Labenne M, Poyart C, Rambaud C. Blind protected specimen brush and bronchoalveolar lavage in ventilated children. Crit Care Med 1999;27:2537–43.

  • Cernada M, Aguar M, Brugada M. Ventilator- associated pneumonia in newborn infants diagnosed with an invasive broncho-alveolar lavage technique: a prospective observational study. Pediatric Crit Care Med 2013; 14:55–61.

  • Woodford N, Ward ME, Kaufmann ME. Community and hospital spread of Escherichia coli producing CTXMextendedspectrum b-lactamases in the UK. J Antimicrob Chemother 2004; 54:735–43.

  • Mcdonald LC, Walker M, Carson L. Outbreak of Acinetobacter spp. Bloodstream infections in a nursery associated with contaminated aerosols and air conditioners. Pediatr Infect Dis J1998;17(3):716-22.

  • Moolenaar RL, Crutcher JM, Sanjoaquin VH. A prolonged outbreak of Pseudomonas aeruginosa in a neonatal intensive care unit: did staff fingernails play a role in disease transmission? Infect Control Hospital Epidemiology 2000;21(2):80-5.


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  • Endo-Tracheal Tube Associated Bacterial Infection, Prevalence and their Drug Susceptibility Pattern in NICU

Abstract Views: 161  |  PDF Views: 138

Authors

S. M. S. Akhatar
Dept of Pediatrics, Zhongnan Hospital of Wuhan University, China
E. E. Mwipopo
Dept of Pediatrics, Zhongnan Hospital of Wuhan University, China
D. Zhao
Dept of Pediatrics, Zhongnan Hospital of Wuhan University, China
W. Li
Dept of Pediatrics, Zhongnan Hospital of Wuhan University, China
M. N. Rahmathullah
Dept of General Surgery, Zhongnan Hospital of Wuhan University, China
M. A. Hassan
Dept of Endocrinology, Zhongnan Hospital of Wuhan University, China

Abstract


Aim of this article is to provide an overview of modifiable and nonmodifiable factor in the development of Nosocomial Infections (NIs) in the Neonatal Intensive Care Units (NICUs).Endotracheal tube intubation/Mechanical ventilation is a lifesaving invasive procedure which is associated with their own potential complications, like ventilator associated pneumonia (VAP), sepsis, Ventilator associated-tracheo-bronchitis(VAT), acute respiratory distress syndrome, pulmonary embolism, Barotrauma and pulmonary edema, which can occur among the patients receiving mechanical ventilation. Among the above listed complication, Neonatal sepsis is the most common and VAP is the second most common encountered Nosocomial infection, which account for the most of the morbidity and mortality in the NICUs and ventilated patients. PubMed, Embase and google scholar have been searched for the articles meeting our criteria,total fourteen articles have been used. Neither any alterations or modifications nor any Software's were used in this article. In some recent research article and literature, some strategy have been mentioned, which are resulting in better control of Nosocomial infection due to ventilator or endotracheal tube intubation. Gram-negative bacteria are most prevalent in the developing countries and Gram-positive in the developed countries, Klebsiella pneumonia, E. coli and staphylococcus aureus are the most common reason for NIs. Increasing number of NIs and multidrug resistance bacteria are matter of concern for Neonatologist around the world.

Keywords


Nosocomial Infection in NICUs, VAP, VAT, Bacterial Prevalence, Antimicrobial Susceptibility.

References





DOI: https://doi.org/10.18311/ijmds%2F2016%2F100629