Gram-Negative Bacilli in Infants Hospitalized in The Neonatal Intensive Care Unit
Sameer J Patel, Nicole Green, Sarah A Clock, David A Paul, Jeffrey M Perlman, Theoklis Zaoutis, Yu-Hui Ferng, Luis Alba, Haomiao Jia, Elaine L Larson, Lisa Saiman, Sameer J Patel, Nicole Green, Sarah A Clock, David A Paul, Jeffrey M Perlman, Theoklis Zaoutis, Yu-Hui Ferng, Luis Alba, Haomiao Jia, Elaine L Larson, Lisa Saiman
Abstract
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.
Keywords: antimicrobial stewardship; bloodstream infections; healthcare-associated infections; neonate; resistance.
© The Author 2016. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
Source: PubMed