Pressão de colonização e infecção de corrente sanguínea por Staphylococcus coagulase-negativo em Unidade de Terapia Intensiva Neonatal

Abstract

Neonates hospitalized in Neonatal Intensive Care Units (NICU) are more susceptible to infections, especially bloodstream infections (BSI) due to the use of invasive devices, such as central venous access, among other factors. One of the main causes of these infections is coagulase-negative Staphylococcus (CoNS), resulting from skin colonization at the insertion site or the catheter hub. This study aimed to determine the prevalence of coagulase-negative Staphylococcus colonization and investigate whether colonization pressure impacted the development of infection in critically ill neonates. A cohort study was conducted based on a prospective study on the pathogenesis of catheter-related BSI in neonates admitted to the NICU of the Federal University of Uberlândia University Hospital (HC-UFU) from December 2010 to August 2012. The study was approved by the UFU Research Ethics Committee. Samples were isolated from blood, catheter tips and hubs, skin, and mucous membranes, being identified and evaluated by the HC-UFU Microbiology Laboratory using Vitek II® (Biomérieux, France). Most neonates presented risk factors such as premature rupture of membranes (68.6%), gestational age < 40 weeks (97.1%), APGAR score < 7 (87.1%), PICC and gastric tubes (> 90%), and weight < 1,500g (67.1%). Although 18.6% were only colonized, 92.3% of which by CoNS, no statistical significance was observed in this analysis. A strong statistical association was found between colonization pressure and the development of infection (p = 0.001). It is concluded that colonization pressure was a significant factor in the development of infection.