Colonization With Antimicrobial-Resistant Gram-Negative Bacilli at Neonatal Intensive Care Unit Discharge
| Autor: | David A. Paul, Setareh Tabibi, Haomiao Jia, Sarah A. Clock, Yu Hui Ferng, Theoklis E. Zaoutis, Luis Alba, Sameer J. Patel, Elaine Larson, Patricia DeLaMora, Lisa Saiman, Jeffrey M. Perlman |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Male Pediatrics medicine.medical_specialty Carbapenem Neonatal intensive care unit medicine.drug_class 030106 microbiology Cephalosporin Population Antibiotics Meropenem Infant Newborn Diseases 03 medical and health sciences 0302 clinical medicine Antibiotic resistance Risk Factors Intensive Care Units Neonatal Drug Resistance Bacterial medicine Humans 030212 general & internal medicine education education.field_of_study Cross Infection business.industry Infant Newborn General Medicine Original Articles Patient Discharge Anti-Bacterial Agents Infectious Diseases Pediatrics Perinatology and Child Health Gentamicin Female business Gram-Negative Bacterial Infections medicine.drug |
| Popis: | In multivariable analysis, prolonged antimicrobial treatment was a predictor of infant colonization with antimicrobial-resistant Gram-negative bacilli within 7 days of discharge from a neonatal intensive care unit. Background. The epidemiology of the colonization of infants with antimicrobial-resistant Gram-negative bacilli (GNB) at discharge from the neonatal intensive care unit (NICU) is not well understood. Methods. A multicenter study in which rectal surveillance samples for culture were obtained at NICU discharge from infants hospitalized 14 days was performed. Factors associated with colonization with GNB resistant to gentamicin, third/fourth-generation cephalosporin agents, or carbapenem agents were assessed by using a fixed-effects model. Results. Of these infants, 9% (119 of 1320) were colonized with 1 antimicrobial-resistant GNB. Prolonged treatment (10 days) with meropenem or third/fourth-generation cephalosporin agents or treatment for 5 days with a β-lactam/β-lactamase combination agent were associated with an increased risk of colonization with GNB resistant to gentamicin. Surgery and 5 days of treatment with third/fourth-generation cephalosporin agents, a β-lactam/β-lactamase combination agent, or metronidazole were associated with an increased risk of colonization with GNB resistant to third/fourth-generation cephalosporin agents. Female sex and prolonged treatment (10 days) with meropenem were associated with colonization with GNB resistant to carbapenem agents. Conclusions. Prolonged treatment with broad-spectrum antibiotics was associated with the colonization of infants with antimicrobial-resistant GNB within 7 days of NICU discharge. These findings suggest the potential for dissemination of resistant GNB from colonized infants to other NICUs, the community, or pediatric longterm care facilities. Antimicrobial stewardship efforts aimed at improving appropriate antibiotic use could havea beneficial effect on the emergence of antimicrobial-resistant GNB in the NICU population. |
| Databáze: | OpenAIRE |
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