Document Detail


Clinical features of nosocomial infections by extended-spectrum beta-lactamase-producing Enterobacteriaceae in neonatal intensive care units.
MedLine Citation:
PMID:  16303704     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To determine the risk factors for the acquisition of nosocomial extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae infection in infants hospitalized in neonatal intensive care units (NICUs) and to evaluate the therapeutic outcome of these infants. METHODS: We retrospectively reviewed the medical records of infants with nosocomial ESBL-producing Enterobacteriaceae infection hospitalized in NICUs at Chang Gung Children's Hospital in 2001. The clinical features of these infants were compared with a cohort of non-ESBL-producing Enterobacteriaceae-infected infants during the same period. The therapeutic outcome of the infants in the ESBL group was analysed. RESULTS: Seventy infants were included in this study. Thirty-one infants with 34 isolates were identified in the ESBL group and 39 infants with 42 isolates in the non-ESBL group. Of the parameters analysed, including gestational age, birthweight, length of hospital stay before onset, the number of antibiotics used, the duration of third-generation cephalosporin usage and the number of patients receiving a third-generation cephalosporin prior to the onset of infection, no significant difference was found between the two groups. The infection-contributed case fatality rate was 3.0% (1 of 33) in the ESBL group, not significantly different from that in the non-ESBL group (1 of 41, 2.4%). Of the 31 patients in the ESBL group, 18 were treated with a carbapenem as definitive therapy while 13 were treated with a non-carbapenem antibiotic regimen. No significant difference was noted in terms of mortality rate between the two subgroups. CONCLUSION: The outcome of the infants hospitalized in the NICU with ESBL-producing enterobacterial infections was not indispensably grave, even when treated with a non-carbapenem antibiotic regimen. The risk factors for the acquisition of ESBL-producing enterobacterial infections in these infants were not identified in this series.
Authors:
Shun Chiu; Yhu-Chering Huang; Rey-In Lien; Yi-Hong Chou; Tzou-Yien Lin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  94     ISSN:  0803-5253     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-23     Completed Date:  2006-02-23     Revised Date:  2010-03-23    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  1644-9     Citation Subset:  IM    
Affiliation:
Division of Pediatric Infectious Diseases, Chang Gung University, Taoyuan, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / therapeutic use
Carbapenems / therapeutic use
Cross Infection / drug therapy,  epidemiology*
Enterobacteriaceae Infections / drug therapy,  epidemiology*
Escherichia coli Infections / epidemiology
Humans
Infant, Newborn
Intensive Care Units, Neonatal
Klebsiella Infections / epidemiology
Klebsiella pneumoniae
Retrospective Studies
Risk Factors
Taiwan / epidemiology
Treatment Outcome
beta-Lactam Resistance*
beta-Lactamases / secretion
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Carbapenems; EC 3.5.2.6/beta-Lactamases

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