Document Detail


No Change in Antibiotic Susceptibility Patterns in the Neonatal ICU Over Two Decades.
MedLine Citation:
PMID:  23254983     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
Zivanit Ergaz; Shmuel Benenson; Matan J Cohen; Rony Braunstein; Benjamin Bar-Oz
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-18
Journal Detail:
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:
Created Date:  2012-12-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
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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