危重新生儿中的耐多药肺炎克雷伯菌：来自巴西队列的证据

IF 2.7 3区医学 Q2 CRITICAL CARE MEDICINE

Australian Critical Care Pub Date : 2025-09-26 DOI:10.1016/j.aucc.2025.101444

Isadora Caixeta da Silveira Ferreira PhD , Ralciane de Paula Menezes PhD , Mallu Santos Mendonça Lopes , Lúcio Borges de Araújo PhD , Daniela Marques de Lima Mota Ferreira PhD , Denise Von Dolinger de Brito Röder PhD

{"title":"危重新生儿中的耐多药肺炎克雷伯菌：来自巴西队列的证据","authors":"Isadora Caixeta da Silveira Ferreira PhD , Ralciane de Paula Menezes PhD , Mallu Santos Mendonça Lopes , Lúcio Borges de Araújo PhD , Daniela Marques de Lima Mota Ferreira PhD , Denise Von Dolinger de Brito Röder PhD","doi":"10.1016/j.aucc.2025.101444","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Antimicrobial resistance is a global health crisis, with multidrug-resistant (MDR) <em>Klebsiella pneumoniae</em> infections causing significant mortality, particularly in low- and middle-income countries.</div></div><div><h3>Objective</h3><div>Evaluate the incidence, risk factors, antimicrobial resistance patterns, and clinical outcomes of <em>K. pneumoniae</em> infections in a neonatal intensive care unit (NICU) in Brazil.</div></div><div><h3>Methods</h3><div>This retrospective cohort study evaluated 1627 neonates in a Brazilian NICU from 2015 to 2022.</div></div><div><h3>Results</h3><div>Invasive <em>K. pneumoniae</em> infections in 3.2% of cases, with a peak incidence of 7% in 2016. Among 62 infection episodes, 54.8% were bloodstream infections and 45.2% urinary tract infections, diagnosed at a median age of 28 days. Most isolates (98.4%) were nonsusceptible, including 41.9% MDR, 6.5% extensively drug-resistant, and 43.5% extended-spectrum beta-lactamase producers, with one carbapenem-resistant isolate. Infection extended hospital stays from 11 to 50 days and had a case fatality rate of 19.2%, with a median time to death of 5 days.</div></div><div><h3>Conclusions</h3><div>The findings underscore the critical burden of MDR <em>K. pneumoniae</em> in NICUs, emphasising the urgent need for targeted antimicrobial stewardship and effective infection control strategies to mitigate neonatal morbidity and mortality.</div></div>","PeriodicalId":51239,"journal":{"name":"Australian Critical Care","volume":"38 6","pages":"Article 101444"},"PeriodicalIF":2.7000,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Multidrug-resistant Klebsiella pneumoniae in critically ill neonates: evidence from a Brazilian cohort\",\"authors\":\"Isadora Caixeta da Silveira Ferreira PhD , Ralciane de Paula Menezes PhD , Mallu Santos Mendonça Lopes , Lúcio Borges de Araújo PhD , Daniela Marques de Lima Mota Ferreira PhD , Denise Von Dolinger de Brito Röder PhD\",\"doi\":\"10.1016/j.aucc.2025.101444\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Antimicrobial resistance is a global health crisis, with multidrug-resistant (MDR) <em>Klebsiella pneumoniae</em> infections causing significant mortality, particularly in low- and middle-income countries.</div></div><div><h3>Objective</h3><div>Evaluate the incidence, risk factors, antimicrobial resistance patterns, and clinical outcomes of <em>K. pneumoniae</em> infections in a neonatal intensive care unit (NICU) in Brazil.</div></div><div><h3>Methods</h3><div>This retrospective cohort study evaluated 1627 neonates in a Brazilian NICU from 2015 to 2022.</div></div><div><h3>Results</h3><div>Invasive <em>K. pneumoniae</em> infections in 3.2% of cases, with a peak incidence of 7% in 2016. Among 62 infection episodes, 54.8% were bloodstream infections and 45.2% urinary tract infections, diagnosed at a median age of 28 days. Most isolates (98.4%) were nonsusceptible, including 41.9% MDR, 6.5% extensively drug-resistant, and 43.5% extended-spectrum beta-lactamase producers, with one carbapenem-resistant isolate. Infection extended hospital stays from 11 to 50 days and had a case fatality rate of 19.2%, with a median time to death of 5 days.</div></div><div><h3>Conclusions</h3><div>The findings underscore the critical burden of MDR <em>K. pneumoniae</em> in NICUs, emphasising the urgent need for targeted antimicrobial stewardship and effective infection control strategies to mitigate neonatal morbidity and mortality.</div></div>\",\"PeriodicalId\":51239,\"journal\":{\"name\":\"Australian Critical Care\",\"volume\":\"38 6\",\"pages\":\"Article 101444\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-09-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Australian Critical Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1036731425002747\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australian Critical Care","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1036731425002747","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}

引用次数: 0

摘要

抗生素耐药性是一项全球卫生危机，耐多药肺炎克雷伯菌感染造成大量死亡，特别是在低收入和中等收入国家。目的评估巴西新生儿重症监护病房（NICU）肺炎克雷伯菌感染的发生率、危险因素、耐药性模式和临床结局。方法回顾性队列研究对2015 - 2022年巴西一家新生儿重症监护病房的1627例新生儿进行评估。结果侵袭性肺炎克雷伯菌感染占3.2%，2016年发病率最高，为7%。在62例感染事件中，54.8%为血液感染，45.2%为尿路感染，诊断时间中位年龄为28天。大多数菌株（98.4%）不敏感，包括41.9%耐多药，6.5%广泛耐药，43.5%广谱β -内酰胺酶产生菌，1株碳青霉烯耐药。感染使住院时间从11天延长至50天，病死率为19.2%，中位死亡时间为5天。结论研究结果强调了耐多药肺炎克雷伯菌对新生儿重症监护病房的严重负担，强调迫切需要有针对性的抗菌药物管理和有效的感染控制策略，以降低新生儿发病率和死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Multidrug-resistant Klebsiella pneumoniae in critically ill neonates: evidence from a Brazilian cohort

Background

Antimicrobial resistance is a global health crisis, with multidrug-resistant (MDR) Klebsiella pneumoniae infections causing significant mortality, particularly in low- and middle-income countries.

Objective

Evaluate the incidence, risk factors, antimicrobial resistance patterns, and clinical outcomes of K. pneumoniae infections in a neonatal intensive care unit (NICU) in Brazil.

Methods

This retrospective cohort study evaluated 1627 neonates in a Brazilian NICU from 2015 to 2022.

Results

Invasive K. pneumoniae infections in 3.2% of cases, with a peak incidence of 7% in 2016. Among 62 infection episodes, 54.8% were bloodstream infections and 45.2% urinary tract infections, diagnosed at a median age of 28 days. Most isolates (98.4%) were nonsusceptible, including 41.9% MDR, 6.5% extensively drug-resistant, and 43.5% extended-spectrum beta-lactamase producers, with one carbapenem-resistant isolate. Infection extended hospital stays from 11 to 50 days and had a case fatality rate of 19.2%, with a median time to death of 5 days.

Conclusions

The findings underscore the critical burden of MDR K. pneumoniae in NICUs, emphasising the urgent need for targeted antimicrobial stewardship and effective infection control strategies to mitigate neonatal morbidity and mortality.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Australian Critical Care NURSING-NURSING

CiteScore

4.90

自引率

9.10%

发文量

148

审稿时长

>12 weeks

期刊介绍： Australian Critical Care is the official journal of the Australian College of Critical Care Nurses (ACCCN). It is a bi-monthly peer-reviewed journal, providing clinically relevant research, reviews and articles of interest to the critical care community. Australian Critical Care publishes peer-reviewed scholarly papers that report research findings, research-based reviews, discussion papers and commentaries which are of interest to an international readership of critical care practitioners, educators, administrators and researchers. Interprofessional articles are welcomed.