Resistance to antimicrobials and vancomycin treatment in neonatal sepsis in a hospital in Brazil

Objective: To describe the antimicrobial resistance profile of strains isolated from neonates with septicemia undergoing vancomycin treatment, to determine the agreement of treatment with guideline and blood cultures, to assess the presence of acute kidney injury (AKI) and the clinical outcome in a...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Rafael H. SILVEIRA, Kelly G. LIMA, Carolina H. SANTOS-BOROWICZ, Karin H. SCHWAMBACH, Hugo BOCK
Formato:	article
Lenguaje:	EN PT
Publicado:	Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde 2020
Materias:	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/4744ebd7f84e4b10b8969fcb288d2c81
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:4744ebd7f84e4b10b8969fcb288d2c81
record_format	dspace
spelling	oai:doaj.org-article:4744ebd7f84e4b10b8969fcb288d2c812021-11-28T02:44:41ZResistance to antimicrobials and vancomycin treatment in neonatal sepsis in a hospital in Brazil10.30968/rbfhss.2020.113.04722179-59242316-7750https://doaj.org/article/4744ebd7f84e4b10b8969fcb288d2c812020-09-01T00:00:00Zhttps://www.rbfhss.org.br/sbrafh/article/view/472https://doaj.org/toc/2179-5924https://doaj.org/toc/2316-7750 Objective: To describe the antimicrobial resistance profile of strains isolated from neonates with septicemia undergoing vancomycin treatment, to determine the agreement of treatment with guideline and blood cultures, to assess the presence of acute kidney injury (AKI) and the clinical outcome in a hospital in Brazil. Methods: A total of 51 newborns treated with vancomycin were studied in the period from January to December 2017. Treatment assessment was verified by the compliance with the Rational Use and Insurance Policy of Antibiotics in Neonatology and blood culture. The presence of AKI was based on the results of serum creatinine. The data were monitored by the computerized system of the laboratory. Results: The main isolated strain was Staphylococcus (coagulase negative) (82.9%), 93.5% with resistance to oxacillin for early infections and 100% for late infections. The same strain showed 54.8% resistance to gentamicin for cases of early sepsis and 66.6% for late sepsis. There were no cases of resistance to vancomycin. The treatments agreed with the reference protocol in 46.3% and with the results of blood cultures in 56%. Only two cases of AKI are observed. Conclusions: The oxacillin-resistant coagulase-negative staphylococcus strains were the main causes of neonatal sepsis. The use of gentamicin for sensitive strains may reduce the use of vancomycin. The results suggest the need for better standardization of the treatment to reduce the risk of toxicity and rational use of therapeutic resources. Rafael H. SILVEIRAKelly G. LIMACarolina H. SANTOS-BOROWICZKarin H. SCHWAMBACHHugo BOCKSociedade Brasileira de Farmácia Hospitalar e Serviços de SaúdearticlePublic aspects of medicineRA1-1270Pharmacy and materia medicaRS1-441Therapeutics. PharmacologyRM1-950ENPTRevista Brasileira de Farmácia Hospitalar e Serviços de Saúde, Vol 11, Iss 3 (2020)
institution	DOAJ
collection	DOAJ
language	EN PT
topic	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950
spellingShingle	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950 Rafael H. SILVEIRA Kelly G. LIMA Carolina H. SANTOS-BOROWICZ Karin H. SCHWAMBACH Hugo BOCK Resistance to antimicrobials and vancomycin treatment in neonatal sepsis in a hospital in Brazil
description	Objective: To describe the antimicrobial resistance profile of strains isolated from neonates with septicemia undergoing vancomycin treatment, to determine the agreement of treatment with guideline and blood cultures, to assess the presence of acute kidney injury (AKI) and the clinical outcome in a hospital in Brazil. Methods: A total of 51 newborns treated with vancomycin were studied in the period from January to December 2017. Treatment assessment was verified by the compliance with the Rational Use and Insurance Policy of Antibiotics in Neonatology and blood culture. The presence of AKI was based on the results of serum creatinine. The data were monitored by the computerized system of the laboratory. Results: The main isolated strain was Staphylococcus (coagulase negative) (82.9%), 93.5% with resistance to oxacillin for early infections and 100% for late infections. The same strain showed 54.8% resistance to gentamicin for cases of early sepsis and 66.6% for late sepsis. There were no cases of resistance to vancomycin. The treatments agreed with the reference protocol in 46.3% and with the results of blood cultures in 56%. Only two cases of AKI are observed. Conclusions: The oxacillin-resistant coagulase-negative staphylococcus strains were the main causes of neonatal sepsis. The use of gentamicin for sensitive strains may reduce the use of vancomycin. The results suggest the need for better standardization of the treatment to reduce the risk of toxicity and rational use of therapeutic resources.
format	article
author	Rafael H. SILVEIRA Kelly G. LIMA Carolina H. SANTOS-BOROWICZ Karin H. SCHWAMBACH Hugo BOCK
author_facet	Rafael H. SILVEIRA Kelly G. LIMA Carolina H. SANTOS-BOROWICZ Karin H. SCHWAMBACH Hugo BOCK
author_sort	Rafael H. SILVEIRA
title	Resistance to antimicrobials and vancomycin treatment in neonatal sepsis in a hospital in Brazil
title_short	Resistance to antimicrobials and vancomycin treatment in neonatal sepsis in a hospital in Brazil
title_full	Resistance to antimicrobials and vancomycin treatment in neonatal sepsis in a hospital in Brazil
title_fullStr	Resistance to antimicrobials and vancomycin treatment in neonatal sepsis in a hospital in Brazil
title_full_unstemmed	Resistance to antimicrobials and vancomycin treatment in neonatal sepsis in a hospital in Brazil
title_sort	resistance to antimicrobials and vancomycin treatment in neonatal sepsis in a hospital in brazil
publisher	Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde
publishDate	2020
url	https://doaj.org/article/4744ebd7f84e4b10b8969fcb288d2c81
work_keys_str_mv	AT rafaelhsilveira resistancetoantimicrobialsandvancomycintreatmentinneonatalsepsisinahospitalinbrazil AT kellyglima resistancetoantimicrobialsandvancomycintreatmentinneonatalsepsisinahospitalinbrazil AT carolinahsantosborowicz resistancetoantimicrobialsandvancomycintreatmentinneonatalsepsisinahospitalinbrazil AT karinhschwambach resistancetoantimicrobialsandvancomycintreatmentinneonatalsepsisinahospitalinbrazil AT hugobock resistancetoantimicrobialsandvancomycintreatmentinneonatalsepsisinahospitalinbrazil
_version_	1718408437580169216

Resistance to antimicrobials and vancomycin treatment in neonatal sepsis in a hospital in Brazil

Ejemplares similares