TY - JOUR
T1 - Gram-negative bacilli in infants hospitalized in the neonatal intensive care unit
AU - Patel, SJ
AU - Green, N
AU - Clock, SA
AU - Paul, DA
AU - Perlman, JM
AU - Zaoutis, T
AU - Ferng, YH
AU - Alba, L
AU - Jia, H
AU - Larson, EL
AU - Saiman, L
N1 - Funding Information:
Financial support. This work was supported by the National Institute of Nursing Research (grant R01 NR010821).
Publisher Copyright:
© The Author 2017. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Background. Gram-negative bacilli (GNB) account for a significant burden of infection and colonization in neonatal intensive care units (NICUs), and antibiotic resistance among these pathogens is of increasing concern. Methods. A prospective cohort study was performed in 4 NICUs between May 2009 and April 2012. The body sites from which GNB were isolated, antimicrobial susceptibilities of the GNB isolated, and antimicrobial therapy were assessed. Results. Attending neonatologists treated 3.0% (188 of 6184) of eligible infants for GNB infection; 23% of 214 GNB isolates were nonsusceptible to antimicrobial agents, including gentamicin (14.8%), piperacillin-tazobactam (9.9%), third-generation cephalosporin (7.0%), and/or carbapenem agents (4.5%). Gentamicin was the most commonly used antibiotic overall, and much of its use was empiric. However, third-generation cephalosporin agents and cefepime were used more commonly as targeted therapy for identified Gram-negative pathogens. Conclusions. One-quarter of the GNB isolates were nonsusceptible to ≥ 1 antibiotic. Antimicrobial stewardship strategies for reducing antimicrobial use in NICUs should be implemented.
AB - Background. Gram-negative bacilli (GNB) account for a significant burden of infection and colonization in neonatal intensive care units (NICUs), and antibiotic resistance among these pathogens is of increasing concern. Methods. A prospective cohort study was performed in 4 NICUs between May 2009 and April 2012. The body sites from which GNB were isolated, antimicrobial susceptibilities of the GNB isolated, and antimicrobial therapy were assessed. Results. Attending neonatologists treated 3.0% (188 of 6184) of eligible infants for GNB infection; 23% of 214 GNB isolates were nonsusceptible to antimicrobial agents, including gentamicin (14.8%), piperacillin-tazobactam (9.9%), third-generation cephalosporin (7.0%), and/or carbapenem agents (4.5%). Gentamicin was the most commonly used antibiotic overall, and much of its use was empiric. However, third-generation cephalosporin agents and cefepime were used more commonly as targeted therapy for identified Gram-negative pathogens. Conclusions. One-quarter of the GNB isolates were nonsusceptible to ≥ 1 antibiotic. Antimicrobial stewardship strategies for reducing antimicrobial use in NICUs should be implemented.
KW - Antimicrobial stewardship
KW - Bloodstream infections
KW - Healthcare-associated infections
KW - Neonate
KW - Resistance
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U2 - 10.1093/jpids/piw032
DO - 10.1093/jpids/piw032
M3 - Article
C2 - 27302327
AN - SCOPUS:85031815250
SN - 2048-7193
VL - 6
SP - 227
EP - 230
JO - Journal of the Pediatric Infectious Diseases Society
JF - Journal of the Pediatric Infectious Diseases Society
IS - 3
ER -