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 : 2024-08-09 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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引用次数: 0

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 (10-39days) 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)