COLONIZATION OF MULTI-RESISTANT MICROORGANISMS IN HOSPITALIZED BABIES AND THEIR MOTHERS IN INTENSIVE CARE UNITS

Premature newborns present immunological e gastrointestinal immaturity, along with epithelial barriers, thus making them more susceptible for colonization with multidrug-resistant microorganisms. The normal colonization process of a newborn begins in the placenta after the rupture of amniotic membrane; and the process continues through direct contact with the mother and its living environment until the neonatal endogenous microbial community is established. The aim of this study was to evaluate the colonization by multidrug-resistant microorganisms in hospitalized newborns and their mothers in Intensive Care Units (ICUs). This is a quantitative, exploratory and prospective case study carried out at the ICU of the University Hospital in southern Brazil with newborns and their mothers from January 2014 to February 2018. The sampling of this study consisted of 604 babies and 570 mothers. Among the babies, 52.6% were male, 71% born by caesarian, 73.5% were underweight, and 76.9% were premature between 34 and 37 weeks. Data from the mothers include an average age of 27 years old, 38.2% had completed high school and 90.0% lived in urban areas. At hospital discharge, a surveillance culture was performed from the newborns and their mothers. One swab each of oral, nasal, axillary and rectal sites was taken from both populations and was inoculated into the selective and enrichment broth media. The cultures were incubated at 37 oC for 24 hours, and those that presented growth were inoculated on the surface of agar selective media. Colonies were subjected to Gram staining and species identification was based on the phenotypic profile generated by disk diffusion and VITEK® 2 Compact. The standard disk diffusion test was performed for ESBL producer detection. Positive culture for multidrug-resistant microorganisms was detected in 145 (24.0%) babies and 64 (11.2%) of the respective mothers. Among colonized babies, 13 (8.9%) showed the same microbial species that was found in the mothers, and the most frequent was Escherichia coli ESBL producer (5/13, 38.5%), followed by Klebsiella spp. ESBL producer (3/13, 23.0%), and Serratia spp. ESBL producer (3/13, 23.0%. Further studies will help to understand the role of the mother and the environment in the colonization of newborns with multidrug-resistant microorganisms.