Challenges and trends in Gram-negative bacterial infections in critically neonates: A seven-and-a-half-year observational study

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control Pub Date : 2025-01-01 DOI:10.1016/j.ajic.2024.08.004

Isadora Caixeta da Silveira Ferreira , Izabella Clara de Brito Machado , Ralciane de Paula Menezes , Thiago Alves de Jesus , Mallu Santos Mendonça Lopes , Lúcio Borges de Araújo , Daniela Marques de Lima Mota Ferreira , Denise Von Dolinger de Brito Röder

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Abstract

Background

Analyze the incidence, risk factors, and fatality rates of bloodstream infections by Gram-negative bacteria (GNB-BSIs) in a Neonatal Intensive Care Unit.

Methods

This study employs a retrospective cohort design utilizing records of neonates admitted to the Neonatal Intensive Care Unit between January 2015 and June 2022.

Results

Among 1,495 neonates, 5.2% developed GNB-BSIs. The average incidence of infection per 1,000 patient-days was 2.9. Primary risk factors for infection that included preceeding carbapenem use were significant risk factors (odds ratio = 514.4; P < .01) and fourth-generation cephalosporins (odds ratio = 66; P < .01). Among the 85 GNB, 75.3% were fermenters, and 24.7% were non-fermenters. Of the isolates, 14.1% produced extended-spectrum beta-lactamase, and 2.3% carbapenem-resistant. Infection correlated with prolonged hospital stays (10-39 days) and increased mortality (10%-29.9%).

Conclusions

The high incidence of GNB-BSIs was exacerbated by the preceeding use of broad-spectrum antimicrobials, increasing the presence of multidrug-resistant isolates and fatality rates. These findings emphasize the importance of active surveillance.

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重症新生儿革兰氏阴性菌感染的挑战与趋势：一项为期七年半的观察研究。

目的分析新生儿重症监护室（NICU）中革兰氏阴性菌血流感染（GNB-BSIs）的发病率、风险因素和死亡率：本研究采用回顾性队列设计，利用2015年1月至2022年6月期间新生儿重症监护室收治的新生儿记录：结果：1495 名新生儿中有 5.2% 感染了 GNB-BSI。每千个患者日的平均感染率为 2.9。感染的主要风险因素包括：使用碳青霉烯类药物之前是重要的风险因素（OR=514.4；第四代头孢菌素（OR=66；PC）结论：GNB-BSI 的高发病率对新生儿的影响非常大：在使用广谱抗菌药物之前，GNB-BSI 的高发病率加剧，增加了耐多药分离株的存在和死亡率。这些发现强调了积极监测的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of infection control 医学-传染病学

CiteScore

7.40

自引率

4.10%

发文量

479

审稿时长

24 days

期刊介绍： AJIC covers key topics and issues in infection control and epidemiology. Infection control professionals, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC)