| Failure of systemic antibiotics to eradicate gram-negative bacilli from the airway of mechanically ventilated very low-birth-weight infants. | |
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MedLine Citation:
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PMID: 10926705 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Gram-negative bacillary (GNB) airway colonization in mechanically ventilated newborns is associated with morbidity and mortality, which may be reduced if systemic antimicrobial therapy eradicates GNB from the airway. Efforts to do so in adults have met with variable success; similar experiences in newborns have not been reported. METHODS: From 1991 through 1998, 531 very low-birth-weight infants were mechanically ventilated longer than 2 weeks. The study group was 106 infants with GNB airway colonization. Sixty-four other neonates in whom GNB nosocomial bloodstream infections developed served as antibiotic treatment outcome control. RESULTS: Isolated from the airway were enteric (70 cases) and environmental (36 cases) GNB. Gentamicin alone or with ceftazidime (79), ceftazidime (11), piperacillin in combination with tazobactam or tobramycin (8), and tobramycin, in combination with ampicillin/sulbactam or mezlocillin (8) were the antimicrobials selected. Systemic antibiotics failed to eradicate GNB colonization in 97% of the cases. Six of the 106 infants with airway colonization died for reasons unrelated to infection. Sixty-four infants experienced 67 bloodstream infections as a result of enteric (53) and environmental (14) GNB. Gentamicin alone (23), with ceftazidime (26), or with clindamycin or ampicillin/sulbactam (9), piperacillin with tazobactam or tobramycin (3) and ceftazidime alone (6) were the antimicrobials selected. Survival occurred in 84% of the 67 nosocomial bloodstream infections. CONCLUSIONS: Systemic antibiotics do not consistently eradicate GNB from the airway of mechanically ventilated newborns, therefore its empirical use for prophylaxis or treatment of airway colonization should be discouraged. |
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Authors:
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L Cordero; M Sananes; L W Ayers |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American journal of infection control Volume: 28 ISSN: 0196-6553 ISO Abbreviation: Am J Infect Control Publication Date: 2000 Aug |
Date Detail:
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Created Date: 2000-10-11 Completed Date: 2000-10-11 Revised Date: 2009-08-14 |
Medline Journal Info:
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Nlm Unique ID: 8004854 Medline TA: Am J Infect Control Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 286-90 Citation Subset: IM |
Affiliation:
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Newborn Services, the Department of Pediatrics, The Ohio State University Medical Center, Columbus, OH 43210-1228, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Academic Medical Centers Anti-Bacterial Agents / administration & dosage, therapeutic use* Antibiotic Prophylaxis / contraindications Cross Infection / blood, drug therapy*, epidemiology Female Gram-Negative Bacteria / drug effects, isolation & purification* Gram-Negative Bacterial Infections / drug therapy*, epidemiology Humans Infant, Newborn Infant, Very Low Birth Weight* Intensive Care Units, Neonatal Male Ohio / epidemiology Respiration, Artificial* Retrospective Studies Treatment Failure |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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