Dermatologia Pediátrica Clínica Acesso livre

Abstrato

Congresso Pediátrico 2019: Infeção da corrente sanguínea em crianças na Bielorrússia - Serhiyenka E N- Universidade Médica do Estado da Bielorrússia

Serhiyenka PT

Abstrato :

Num estudo retrospetivo de 2009 a 2017, foi estudado o padrão etiológico identificado de bacteremia. Só durante o período previsto, foram cultivados 655 agentes patogénicos a partir de hemoculturas em 515 doentes com idades compreendidas entre as 3 semanas e os 18 anos. De acordo com os resultados do estudo, a proporção de bactérias gram-negativas passou para 31,7%, bactérias gram-positivas -61,9%, fungos -6,4%. A fungémia foi registada em anos distintos de 2,2 (2013) a 14,7% (2010) de todas as hemoculturas fantásticas. A Candida parapsilosis prevalece dentro da estrutura dos agentes patogénicos (64,3%) e 27 ocorrências 64,3%) do género Torulopsis. Entre os microrganismos isolados prevaleceram os estafilococos (41%), o 2º lugar na frequência de isolamento passou a ser ocupado por microrganismo não fermentador (16,7%), o terceiro lugar-microrganismo da família Enterobacteriacae (14,1 %) e 4ª vizinhança – estreptococos (10,8%). O espectro de microrganismos gram-pobres dentro da própria família Enterobacteriacae (n=86) é diverso: Escherichia – 10,5%, Salmonella – 5,8%, Shigella – 25,6%, Proteus mirabilis – 1,15%, Providencia stuartii – 1,15% , Serratia – 15,1%, Klebsiella – 27,9%, Enterobacter – 10,5% e outras – 2 (2,3%). As bactérias Gram-terríveis não fermentadoras foram isoladas em 102 (16,7%) episódios de bacteremia. Entre eles predominaram Acinetobacter – 47,1%, Pseudomonas – 20,6%, Achromobacter – 12,7% e Stenotrophomonas maltophilia – 7,8%. A estrutura das bactérias Gram-nice (n = 404) foi governada por estafilococos (62,1%), com o máximo de tipos frequentemente isolados de coagulase-má (84,5%). Sob a forma de todos os estafilococos (n=251), o S. Aureus passou a ser determinado com uma frequência de 15,1%, sendo o mais comum transformado em S. Dermis – 63,3% dos casos. Os estreptococos (n=66) foram controlados por Str. Pneumonia (27,3%) e Str. Agalacia (19,7%) e Str. Grupos Viridans (15,2%). Os enterococos foram isolados em 31 doentes (5,1%), com uma frequência quase igual dominada por Enterococcus faecalis e Enterococcus faecium (41,9% e 38,7%, respetivamente). Durante o período de estudo foram isoladas 7 (1,1%) estirpes de Corynebacterium spp.

Blood cultures continue to be the mainstay of laboratory diagnosis of bloodstream infections (BSIs) in babies and youngsters. Recovery of a pathogen is effective, because it confirms the prognosis of bacteremia and allows for identity and susceptibility trying out at the organism to optimize antimicrobial therapy and length. A bad blood subculture is simply as critical, because it regulations out cases of bacteremia and prompts continued research of different infectious or noninfectious etiologies or cessation of useless empirical antimicrobial therapy.

The majority of research related to the laboratory diagnosis of BSI cognizance at the person populace. Thus, this minireview can be committed to kids and the multifactorial factors worried in obtaining an most excellent pediatric blood tradition specimen, consisting of timing, quantity, and bottle selection. Lastly, a discussion on the rapid diagnostic strategies presently to be had and their impact on pediatric control and results will be reviewed.

The two above studies mentioned correlation among blood cultures that were fantastic with noncontaminant micro-organism and ok blood extent (prevalence rates of 60% to 71%). In comparison, the research determined that procurement of low blood quantity inversely correlated with blood tradition infection fees. 60-5 percent of effective blood cultures deemed to be contaminants had insufficient blood volume, and restoration of contaminant turned into two times as probably while inadequate blood volume became obtained (5.1% versus 2.8%). These findings further aid the need of acquiring enough blood tradition volume, as the recovery of contaminants has been suggested in 25% to 69% of all fantastic blood cultures in pediatric patients and is associated with needless antimicrobial therapy, prolonged hospitalization, and incurred cost. It isn't in particular clean why low extent blood cultures are more prone to yield contaminants; one idea is that the purchase of contaminants is unbiased of blood extent, and as a substitute the collection of larger blood extent dilutes the awareness of the contaminant present inside the blood subculture bottle, lowering the danger of detection at some point of the incubation duration.

In conclusion, there are restricted records to set up the top-rated series quantity in children, and most people of records is extrapolated from research in grownup populations. A safe and suitable technique is that the collection of blood ought to be proportionate to the patient's total blood quantity and, greater specifically, the affected person's weight. There is a lack of consensus among the present day pointers for pediatric blood collection. The maximum current suggestions from the Infectious Diseases Society of America (IDSA) and the American Society of Microbiology (ASM) advocate the collection of 3% to 4% of overall affected person blood quantity in sufferers weighing <12.7 kg and 1.8% to 2.7% in patients weighing>12.8 kg