caa a22 4500 606155309 CHVBK 20210128100602.0 cr unu---uuuuu 210128e20150101xx s 000 0 eng 10.1007/s10096-014-2220-x doi (NATIONALLICENCE)springer-10.1007/s10096-014-2220-x Prevalence of respiratory colonisations and related antibiotic resistances among paediatric tracheostomised patients of a long-term rehabilitation centre in Italy [Elektronische Daten] [M. Pozzi, P. Pellegrino, S. Galbiati, M. Granziera, F. Locatelli, C. Carnovale, V. Perrone, S. Antoniazzi, C. Perrotta, S. Strazzer, E. Clementi] Patients with brain injury are prone to bacterial colonisations because of mechanical ventilation during intensive care and the long-term retention of tracheostomical tubes during rehabilitation. Reduced levels of isolation, typical of rehabilitation, could also contribute to propagate colonisations. We evaluated the presence of bacteria through different stages of healthcare, their antibiotic resistances and their clinical impact in a rehabilitation setting. This retrospective study included all tracheostomised patients referred to the paediatric brain injury unit of the Scientific Institute IRCCS E. Medea (Italy) over a six-year period. Data were collected from antibiograms regarding the presence of bacterial species and antibiotic resistances; clinical data were collected from medical records. Antibiograms revealed bacteria and antibiotic resistances typical of intensive care, while prevalence patterns were characteristic for each species (P. aeruginosa and S. aureus prevailing in the acute setting, K. pneumoniae, A. baumannii and others in rehabilitation). Despite very frequent antibiotic resistances, consistent with Italian averages, we observed a limited clinical impact for these colonisations. We analysed risk factors correlating to the development of respiratory symptoms and found a role for the acute clinical course after brain injury (having undergone neurosurgery; duration of intensive care stay) as well as for rehabilitation (duration of coma). Our data suggest that, in a long-term perspective, an appropriate balance is yet to be found between patient isolation and social interactions, to control respiratory colonisations and antibiotic resistances without compromising rehabilitation. They also suggest that regular containment measures should be complemented by thorough training to non-medic personnel and parents alike. Springer-Verlag Berlin Heidelberg, 2014 Pozzi M. U.O. Gravi Cerebrolesioni Acquisite NR3, Scientific Institute IRCCS Eugenio Medea, 23842, Bosisio Parini, Lecco, Italy aut Pellegrino P. Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco” University Hospital, Università di Milano, 20157, Milan, Italy aut Galbiati S. U.O. Gravi Cerebrolesioni Acquisite NR3, Scientific Institute IRCCS Eugenio Medea, 23842, Bosisio Parini, Lecco, Italy aut Granziera M. U.O. Gravi Cerebrolesioni Acquisite NR3, Scientific Institute IRCCS Eugenio Medea, 23842, Bosisio Parini, Lecco, Italy aut Locatelli F. U.O. Gravi Cerebrolesioni Acquisite NR3, Scientific Institute IRCCS Eugenio Medea, 23842, Bosisio Parini, Lecco, Italy aut Carnovale C. Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco” University Hospital, Università di Milano, 20157, Milan, Italy aut Perrone V. Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco” University Hospital, Università di Milano, 20157, Milan, Italy aut Antoniazzi S. IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy aut Perrotta C. Unit of Clinical Pharmacology, CNR Institute of Neuroscience, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco” University Hospital, Università di Milano, Via GB Grassi 74, 20157, Milano, Italy aut Strazzer S. U.O. Gravi Cerebrolesioni Acquisite NR3, Scientific Institute IRCCS Eugenio Medea, 23842, Bosisio Parini, Lecco, Italy aut Clementi E. U.O. Gravi Cerebrolesioni Acquisite NR3, Scientific Institute IRCCS Eugenio Medea, 23842, Bosisio Parini, Lecco, Italy aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/1(2015-01-01), 169-175 0934-9723 34:1<169 2015 34 10096 https://doi.org/10.1007/s10096-014-2220-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-014-2220-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Pozzi M. U.O. Gravi Cerebrolesioni Acquisite NR3, Scientific Institute IRCCS Eugenio Medea, 23842, Bosisio Parini, Lecco, Italy aut NATIONALLICENCE 700 1- Pellegrino P. Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco” University Hospital, Università di Milano, 20157, Milan, Italy aut NATIONALLICENCE 700 1- Galbiati S. U.O. Gravi Cerebrolesioni Acquisite NR3, Scientific Institute IRCCS Eugenio Medea, 23842, Bosisio Parini, Lecco, Italy aut NATIONALLICENCE 700 1- Granziera M. U.O. Gravi Cerebrolesioni Acquisite NR3, Scientific Institute IRCCS Eugenio Medea, 23842, Bosisio Parini, Lecco, Italy aut NATIONALLICENCE 700 1- Locatelli F. U.O. Gravi Cerebrolesioni Acquisite NR3, Scientific Institute IRCCS Eugenio Medea, 23842, Bosisio Parini, Lecco, Italy aut NATIONALLICENCE 700 1- Carnovale C. Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco” University Hospital, Università di Milano, 20157, Milan, Italy aut NATIONALLICENCE 700 1- Perrone V. Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco” University Hospital, Università di Milano, 20157, Milan, Italy aut NATIONALLICENCE 700 1- Antoniazzi S. IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy aut NATIONALLICENCE 700 1- Perrotta C. Unit of Clinical Pharmacology, CNR Institute of Neuroscience, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco” University Hospital, Università di Milano, Via GB Grassi 74, 20157, Milano, Italy aut NATIONALLICENCE 700 1- Strazzer S. U.O. Gravi Cerebrolesioni Acquisite NR3, Scientific Institute IRCCS Eugenio Medea, 23842, Bosisio Parini, Lecco, Italy aut NATIONALLICENCE 700 1- Clementi E. U.O. Gravi Cerebrolesioni Acquisite NR3, Scientific Institute IRCCS Eugenio Medea, 23842, Bosisio Parini, Lecco, Italy aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/1(2015-01-01), 169-175 0934-9723 34:1<169 2015 34 10096