title: [Trend of antimicrobial susceptibility in a neonatal and pediatric intensive care unit].
abstract: BACKGROUND
  Nosocomial infections in intensive care units are a health problem worldwide due to their incidence, prevalence and clinical impact. The objective of this article was to describe the trend of antimicrobial susceptibility during a 10-years period in both a pediatric and a neonatal intensive care unit.
  
  
  METHODS
  This is a follow-up cohort study. In 10 years of follow-up, the antimicrobial used was considered the independent variable, and the antimicrobial susceptibility as the dependent variable. By using chi squared with Fisher exact test, the initial and final susceptibilities were compared, and also the most prevalent diagnoses and the antimicrobials. A two-tailed p value < 0.05 was considered statistically significant. SPSS 8 and Epi-Info 0.6 were used for statistical analysis.
  
  
  RESULTS
  Antimicrobial susceptibility decreased from 66 to 45 % in 10 years, representing a global loss of 13 % (p = 0.002). The most affected antimicrobials were first-generation cephalosporin (p = 0.02), ciprofloxacin (p = 0.05), erythromycin (p = 0.001), imipenem (p = 0.001), and trimethoprim/sulfamethoxazole (p = 0.05).
  
  
  CONCLUSIONS
  There is an alarming loss of effectiveness in antimicrobial agents.
authors.affiliation: Servicio de Pediatría, Hospital General Regional 110, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México. albertovillamanzano@yahoo.com.mx.
authors.forename: María G
authors.initials: MG
authors.lastname: Vázquez-Solís
authors.forename: Alberto I
authors.initials: AI
authors.lastname: Villa-Manzano
authors.forename: Luis H
authors.initials: LH
authors.lastname: Medina-García
authors.forename: X Xitlalli
authors.initials: XX
authors.lastname: Zamora-López
authors.forename: Carlos
authors.initials: C
authors.lastname: Pulido-Galaviz
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Zamora-López
mesh_terms: D000293:Adolescent; D000890:Anti-Infective Agents / Q000494:pharmacology*; D002176:Candida albicans / Q000187:drug effects* / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D025141:Drug Resistance, Fungal; D005500:Follow-Up Studies; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000639:trends*; D008800:Mexico; D008826:Microbial Sensitivity Tests; D011446:Prospective Studies
chemical_list: D000890:Anti-Infective Agents
keywords: Anti-infective agents; Intensive care units; Microbial drug resistance; Microbial sensitivity tests; Pediatrics