Multi - Drug Resistant Organisms in Neonatal Sepsis in 2 Tertiary Neonatal Intensive Care Units , Egypt

2015 ◽  
Vol 32 (1-2) ◽  
pp. 1-18
Author(s):  
Hesham A. Awad ◽  
Nabil F. Badran ◽  
Manal Mohsen
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Drug Resistant

scholarly journals High Frequency of Multidrug-Resistant Gram-Negative Rods in 2 Neonatal Intensive Care Units in the Philippines

2009 ◽  
Vol 30 (6) ◽  
pp. 543-549 ◽  
Author(s):  
Jennifer M. Litzow ◽  
Christopher J. Gill ◽  
Jose B. V. Mantaring ◽  
Matthew P. Fox ◽  
William B. MacLeod ◽  
...  
Keyword(s):  
Risk Factor ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Independent Risk Factor ◽  
Multidrug Resistant ◽  
The Philippines ◽  
Neonatal Intensive Care Units ◽  
Drug Resistant ◽  
Gram Negative

Background.Although hospital-acquired infections appear to be a growing threat to the survival of newborns in the developing world, the epidemiology of this problem remains poorly characterized.Methods.During a 10-month period, we conducted prospective longitudinal surveillance for colonization and bloodstream infection caused by gram-negative rods among all infants hospitalized in the 2 largest neonatal intensive care units in Manila, the Philippines. We determined antibiotic susceptibilities and calculated adjusted odds ratios for risk factors for bacteremia by means of multivariate logistic regression.Results.Of 1,831 neonates enrolled during a 10-month period, 1,017 (55.5%) became newly colonized and 358 (19.6%) became bacteremic with a drug-resistant gram-negative rod, most commonly Klebsiella species, Enterobacter species, Acinetobacter species, and Pseudomonas aeruginosa. Of the invasive isolates, 20% were resistant to imipenem, 41% to trimethoprim-sulfamethoxazole, 52% to amikacin, 63% to ampicillin-sulbactam, 67% to ceftazidime, and 80% to tobramycin. The factors significantly associated with an increased risk of bacteremia were mechanical ventilation and prematurity. Additionally, colonization with a drug-resistant gram-negative rod was an independent risk factor for bacteremia (odds ratio, 1.4 [95% confidence interval, 1.0-1.9]).Conclusions.Colonization with a drug-resistant gram-negative rod was an independent risk factor for sepsis. If our data are typical, the unusually high intensity of colonization pressure and disease caused by multidrug-resistant gram-negative rods at these 2 neonatal intensive care units indicates an emerging healthcare crisis in the developing world. Improved infection control methods are therefore critically needed in developing countries.

scholarly journals Variations in Antibiotic Use and Sepsis Management in Neonatal Intensive Care Units: A European Survey

Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1046
Author(s):  
Felipe Garrido ◽  
Karel Allegaert ◽  
Cristina Arribas ◽  
Eduardo Villamor ◽  
Genny Raffaeli ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Sepsis ◽  
Clinical Guidelines ◽  
Neonatal Intensive Care ◽  
Online Survey ◽  
Late Onset ◽  
Antibiotic Use ◽  
Neonatal Intensive Care Units ◽  
Sepsis Management

Management of neonatal sepsis and the use of antimicrobials have an important impact on morbidity and mortality. However, there is no recent background on which antibiotic regimens are used in different European neonatal intensive care units (NICUs). Our study aimed to describe the use of antibiotics and other aspects of early- and late-onset sepsis (EOS and LOS, respectively) management by European NICUs. We conducted an online survey among NICUs throughout Europe to collect information about antibiotic stewardship, antibiotic regimens, and general aspects of managing neonatal infections. NICUs from up to 38 European countries responded, with 271 valid responses. Most units had written clinical guidelines for EOS (92.2%) and LOS (81.1%) management. For EOS, ampicillin, penicillin, gentamicin, and amikacin were the most commonly used antibiotics. Analysis of the combinations of EOS regimens showed that the most frequently used was ampicillin plus gentamicin (54.6%). For LOS, the most frequently used antibiotics were vancomycin (52.4%), gentamicin (33.9%), cefotaxime (28%), and meropenem (15.5%). Other aspects of the general management of sepsis have also been analyzed. The management of neonatal sepsis in European NICUs is diverse. There was high self-reported adherence to the local clinical guidelines. There was homogeneity in the combination of antibiotics in EOS but less in LOS.

scholarly journals Invasive devices as risk factors for neonatal sepsis in neonatal intensive care units

2020 ◽  
Vol 9 (12) ◽  
pp. e27891211048
Author(s):  
Juliana Barbosa Schwab ◽  
Erildo Vicente M¨¨¨¨¨¨uller ◽  
Elisa Donalisio Teixeira Mendes ◽  
Pollyanna Kássia de Oliveira Borges ◽  
Taís Ivastcheschen
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Mortality Rate ◽  
Intensive Care Units ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Neonatal Intensive Care Units ◽  
Late Onset Sepsis ◽  
The Impact

This study aimed to evaluate the impact of invasive devices as risk factors for the development of neonatal sepsis in Neonatal Intensive Care Units. Hospital-based retrospective cohort study performed in two Neonatal Intensive Care Units in Ponta Grossa, Paraná, Brazil. Documentary data were collected through consultation of electronic medical charts of all patients admitted to two hospitals and of the patients with diagnosis of sepsis in another hospital. Health conditions at admission and outcomes were evaluated. Frequencies of the reasons for admission and the outcomes were calculated. In the association analysis, exposure variables were calculated with odds ratio and confidence intervals (95%). The frequency of sepsis was 39%, and 45.7% of the cases were of early-onset sepsis and 54.3% of late-onset sepsis. The mortality rate associated with sepsis was 9.9%. The use of invasive devices was observed to increase by 6 times the risk of neonatal sepsis. Peripherally inserted central catheter and phlebotomy were the devices causing higher risk. The high incidence of late-onset sepsis, its association with the use of invasive devices and the higher mortality rate among newborns with sepsis suggest the presence of fragilities in neonatal care and the need to seek alternatives of neonatal approach to avoid new cases of neonatal sepsis and consequent death.

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