Challenges and Trends in Gram-Negative Bacterial Infections in Critically Neonates: A Seven-and-a-Half-Year Observational Study
Neonatal Medicine
Challenges and Trends in Gram-Negative Bacterial Infections in Critically Neonates: A Seven-and-a-Half-Year Observational Study
Neonatal Medicine

Challenges and Trends in Gram-Negative Bacterial Infections in Critically Neonates: A Seven-and-a-Half-Year Observational Study

Am J Infect Control. 2024 Aug 9:S0196-6553(24)00638-2. doi: 10.1016/j.ajic.2024.08.004. Online ahead of print.

ABSTRACT

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

METHODS: This study employs a retrospective cohort design utilizing records of neonates admitted to the NICU between January 2015 and June 2022.

RESULTS: Among 1,495 neonates, 5.2% developed GNB-BSIs. The average incidence of infection/1,000 patient-days was 2.9. Primary risk factors for infection included preceeding carbapenem use were significant risk factors (OR=514.4; P<0.01) and 4th generation cephalosporins (OR=66; P<0.01). 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 to 39 days) and increased mortality (10% to 29.9%).

CONCLUSION: 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.

PMID:39128485 | DOI:10.1016/j.ajic.2024.08.004