| No Change in Antibiotic Susceptibility Patterns in the Neonatal ICU Over Two Decades. | |
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MedLine Citation:
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PMID: 23254983 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVES:: To identify trends in early-onset sepsis and late-onset sepsis neonatal rates and to evaluate the appropriateness of the empirical antibiotic protocols. DESIGN:: A 17-yr (1993-2009) analysis of positive blood and cerebrospinal fluid cultures. SETTING:: The two neonatal ICUs at the Hadassah-Hebrew University Medical Center. RESULTS:: During this period, 991 infants had at least one episode of either bacteremia or meningitis. The overall incidence of early-onset sepsis was 0.64 per 1,000 live births with a nonsignificant trend over the study period (p = 0.37). The overall incidence of late-onset sepsis was 7.5 per 100 admissions with a significant positive trend in the incidence rates (p = 0.021). The incidence of late-onset sepsis was 7.5 per 100 admissions with a significant positive trend in the prevalence rates (p = 0.021). The prevalence of early-onset group B Streptococcus bacteremia decreased significantly throughout the study period. Among late-onset sepsis, Gram-positive and fungi infection rates were stable over time, while Gram-negative infection rates showed a significant positive trend (p = 0.007). No significant change in the susceptibility rate of the isolated Gram-negative bacteria in late-onset sepsis for the common antibacterial drugs was found. About 85% and 90% of the isolated organisms were susceptible to our early-onset sepsis (ampicillin and gentamicin) and late-onset sepsis (vancomycin and cefotaxime) protocols, respectively, and these rates were stable over the study period (p = .1 and .55, respectively). Sepsis-related mortality was higher among Gram-negative sepsis cases resistant to our empiric antibiotic protocol. CONCLUSIONS:: Our empiric antibiotic protocols are appropriate despite their continuous use over the last 17 yrs. This may have been achieved by the use of a controlled antibiotic program and infection control efforts. |
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Authors:
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Zivanit Ergaz; Shmuel Benenson; Matan J Cohen; Rony Braunstein; Benjamin Bar-Oz |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-12-18 |
Journal Detail:
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Title: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies Volume: - ISSN: 1529-7535 ISO Abbreviation: Pediatr Crit Care Med Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-12-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100954653 Medline TA: Pediatr Crit Care Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1 Department of Neonatology, Hadassah - Hebrew University Medical Center, Jerusalem, Israel. 2 Department of Clinical Microbiology and Infectious Diseases, Hadassah - Hebrew University Medical Center, Jerusalem, Israel. 3 Center for Clinical Quality and Safety, Hadassah - Hebrew University Medical Center, Jerusalem, Israel. 4 Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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