| spelling |
2023-04-14T21:41:53Z2023-04-14T21:41:53Z2021973329334https://doi.org/10.1016/j.jped.2020.06.0011678-4782http://hdl.handle.net/1843/52032https://orcid.org/0000-0002-8264-0532https://orcid.org/0000-0002-3336-9504https://orcid.org/0000-0002-9408-2822https://orcid.org/0000-0002-1833-8099https://orcid.org/0000-0003-0848-3740https://orcid.org/0000-0001-8402-2060https://orcid.org/0000-0003-3193-5469https://orcid.org/0000-0002-1660-0751Objective: The use of broad-spectrum antimicrobials, such as third and fourth-generation, are responsible for emergence of multidrug-resistant microorganisms in neonatal units. Furthermore, antimicrobial daily doses are not standardized in neonatology. This study aimed to investigate the association between the use of antimicrobial broad spectrum to bacterial sensitivity profile in a referral unit of neonatal progressive care. Methods: This is a cohort study conducted in a referral neonatal progressive care unit from January 2008 to December 2016. The data of all hospitalized neonates was collected daily. The infection criteria used were the standardized national criteria, based on definitions of Center for Diseases Control and Prevention. In this study, the use of antimicrobials was evaluated as antimicrobial-day (ATM-day) and the ratio of multidrug-resistant microorganisms per 1000 ATMday of broad spectrum was also calculated. The study was approved by the Institutional Review Board of the Universidade Federal de Minas Gerais (ETIC 312/08 e CAAE 58973616.2.0000.5149). Results: From 2008 to 2016, 2751 neonates were hospitalized, corresponding to 60,656 patientdays. The ratio of multidrug-resistant microorganisms per 1000 ATM-day of broad spectrum was 1,3 in the first period and 4,3 in the second period (p = 0,005). Conclusion: It was observed that use of broad-spectrum antimicrobials, especially those with coverage for Gram-negative bacteria, was associated with an increase of multidrug-resistant bacteria.Objetivo: O uso de antimicrobianos de amplo espectro, como os de terceira e quarta geração, são responsáveis pelo surgimento de microrganismos multirresistentes em unidades neonatais. Além disso, as doses diárias de antimicrobianos não são padronizadas em neonatologia. Este estudo teve como objetivo investigar a associação entre o uso de antimicrobiano de amplo espectro com o perfil de sensibilidade bacteriana em uma unidade de referência em cuidados neonatais progressivos. Métodos: Trata-se de um estudo de coorte realizado em uma unidade de cuidados progressivos neonatais de referência no período de janeiro de 2008 a dezembro de 2016. Os dados de todos os neonatos internados foram coletados diariamente. Os critérios de infecção utilizados foram os critérios nacionais padronizados, baseados nas definições do Centro de Controle e Prevenção de Doenças. Neste estudo, o uso de antimicrobianos foi avaliado como antimicrobiano-dia (ATM-dia) e também foi calculada a razão de microrganismos multirresistentes por 1000 ATMdia de amplo espectro. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Minas Gerais (ETIC 312/08 e CAAE 58973616.2.0000.5149). Resultados: De 2008 a 2016, foram internados 2.751 neonatos, correspondendo a 60.656 pacientes-dia. A razão de microrganismos multirresistentes por 1000 ATM-dia de amplo espectro foi de 1,3 no primeiro período e 4,3 no segundo período (p = 0,005). Conclusão: Observou-se que o uso de antimicrobianos de amplo espectro, principalmente aqueles com cobertura para bactérias Gram-negativas, esteve associado ao aumento de bactérias multirresistentes.Outra AgênciaengUniversidade Federal de Minas GeraisUFMGBrasilHCL - HOSPITAL DAS CLINICASMED - DEPARTAMENTO DE PEDIATRIAMED - DEPARTAMENTO DE PROPEDÊUTICA COMPLEMENTARJornal de PediatriaRecém-nascidoLactenteSaúde do lactenteAnti-infecciososResistência a medicamentosControle de infecçõesNewbornInfantAnti-infective agentsDrug resistanceMicrobialInfection controlAntimicrobial use for treatment of healthcare-associated infections and bacterial resistance in a reference neonatal unitUso de antimicrobianos para tratamento de infecções relacionadas à assistência à saúde e resistência bacteriana em uma unidade neonatal de referênciainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://www.sciencedirect.com/science/article/pii/S0021755720301844?via%3DihubAna Carolina Bueno e SilvaLeni Márcia AnchietaViviane RosadoJanita FerreiraWanessa Trindade ClementeJulia Sampaio CoelhoPaulo Henrique Orlandi MourãoRoberta Maia de Castro Romanelliapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/52032/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALAntimicrobial use for treatment of healthcare-associated infections and bacterial resistance in a reference neonatal unit.pdfAntimicrobial use for treatment of healthcare-associated infections and bacterial resistance in a reference neonatal unit.pdfapplication/pdf351343https://repositorio.ufmg.br/bitstream/1843/52032/2/Antimicrobial%20use%20for%20treatment%20of%20healthcare-associated%20infections%20and%20bacterial%20resistance%20in%20a%20reference%20neonatal%20unit.pdfcac3c767ce9f9af03e4dfdbf6dacf397MD521843/520322023-04-14 18:41:53.895oai:repositorio.ufmg.br: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Repositório InstitucionalPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-04-14T21:41:53Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
|