ArticlesReduction in colonization and nosocomial infection by multiresistant bacteria in a neonatal unit after institution of educational measures and restriction in the use of cephalosporins*
Section snippets
Patients and Methods
In 1995 the neonatal unit consisted of 30 beds, divided into 8 intensive care beds (2 wards of 4 beds) and 22 intermediate care beds. This nursery is located in a teaching hospital, and it serves as a reference to a region with 3 million inhabitants. The number of births in the last 5 years averaged 3152 a year, being 17.3% of low–birth-weight and 4.1% of very-low–birth-weight babies. The number of admissions to the high-risk nursery was approximately 600 babies a year.
An infection control
Results
During the first phase of the study, 67 samples from 31 patients were cultured (31 rectal swabs, 31 umbilical swabs, and 5 tracheal aspirates). The positivity of the cultures was 71.6% (83.9% of the rectal swabs, 58% of the umbilical swabs, 80% of the tracheal aspirates). In 16.1% of the patients, no bacteria were isolated. Among 26 patients, 50 bacterial strains were isolated. Gram-negative strains represented 72% of the positive cultures. E cloacae was isolated in 45.2% (14/31) of the
Discussion
The first part of the study served as a motivating tool to the neonatal unit staff. This was an important goal to be achieved because by that time, almost half of the patients admitted to the unit were colonized byE cloacae , two thirds of which were multiresistant.
Considering that 93% of the E cloacae strains were sensitive to amikacin, this drug was chosen to replace ceftriaxone and gentamicin (to whom respectively 35.7% and 50% of the strains were sensitive) as one of the first-line drugs to
Acknowledgements
We thank Joaquim Murray Bustorff Silva, MD, for the review of this article.
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