Does the COVID-19 pandemic have influenced the profile of primary bloodstream infections in critically ill neonates?

Helio de Souza Junior, Zilka dos Santos de Freitas Ribeiro, Jeane Kelly Silva de Carvalho, Priscila Stephanny Penha da Silva, Thatiane Ferreira da Conceição, Paula Regina de Souza Hermann
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Abstract

Introduction: Primary Bloodstream Infection (PBSI) associated with Central Venous Catheters (CVC) is the primary site of healthcare-associated infections in Neonatal Intensive Care Units (NICUs). Aim: To assess the occurrence of PBSI associated with Peripherally Inserted Central Catheters (PICC) in neonates, before and during the COVID-19 pandemic. Outlining: We conducted a retrospective cohort analysis in the NICU of a teaching hospital in the Federal District, Brazil. The sample included 169 neonates who used PICCs from 2018 to 2021. Results: There were 16 primary bloodstream infections, with 50% occurring in the pre pandemic period and 50% during the pandemic. Additionally, 267 blood cultures were performed, of which 17.23% were positive, including 61.7% gram-positive microorganisms and 36.17% gram-negative. The primary microorganisms identified were Klebsiella spp. and coagulase-negative Staphylococcus, with one microorganism exhibiting oxacillin resistance. Implications: We emphasize the importance of monitoring and maintaining continuous surveillance of PBSI associated with CVC, especially during events like the COVID-19 pandemic. Stringent infection control measures should be implemented to minimize the risk of infection and improve care in neonatal intensive care units.
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COVID-19 大流行是否影响了重症新生儿原发性血流感染的概况?
导言:与中心静脉导管 (CVC) 相关的原发性血流感染 (PBSI) 是新生儿重症监护病房 (NICU) 中医疗相关感染的主要部位。目的:评估 COVID-19 大流行之前和期间新生儿外周置入中心导管 (PICC) 相关 PBSI 的发生情况。概述:我们在巴西联邦区一家教学医院的新生儿重症监护室进行了一项回顾性队列分析。样本包括 2018 年至 2021 年期间使用 PICC 的 169 名新生儿。分析结果共有16例原发性血流感染,其中50%发生在大流行前,50%发生在大流行期间。此外,共进行了 267 次血培养,其中 17.23% 为阳性,包括 61.7% 的革兰氏阳性微生物和 36.17% 的革兰氏阴性微生物。鉴定出的主要微生物是克雷伯氏菌属和凝固酶阴性葡萄球菌,其中一种微生物对奥沙西林产生耐药性。影响:我们强调监测和持续监控与 CVC 相关的 PBSI 的重要性,尤其是在 COVID-19 大流行期间。应实施严格的感染控制措施,将感染风险降至最低,并改善新生儿重症监护病房的护理工作。
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