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Utility of Surveillance Cultures for Antimicrobial Resistant Organisms in Infants Transferred to the Neonatal Intensive Care Unit.
MedLine Citation:
PMID:  23811747     Owner:  NLM     Status:  Publisher    
BACKGROUND:: Infections with antibiotic resistant organisms (AROs) are an important source of morbidity and mortality among infants hospitalized in the neonatal intensive care unit (NICU). To identify potential reservoirs of AROs in the NICU, active surveillance strategies have been adopted by many NICUs to detect infants colonized with AROs. However, the yield, risks, benefits, and costs of different strategies have not been fully evaluated.
METHODS:: We conducted a retrospective study in two level III NICUs from 2004-2010 to investigate the yield of surveillance cultures obtained from infants transferred to the NICU from other hospitals. Cultures were processed for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and antibiotic resistant gram negative rods (AR-GNR). Risk factors, selected outcomes, and laboratory costs associated with ARO-colonization were assessed.
RESULTS:: Among 1751 infants studied, the rate of colonization for MRSA, VRE, and AR-GNR was 3%, 1.7%, and 1% respectively. Age at transfer was the strongest predictor of ARO colonization; infants transferred at ≥ 7 days of life had 5.8 increased odds of ARO colonization compared with infants < 7 days of age. Transferred infants who were colonized had similar rates of mortality, ARO infection, and duration of hospitalization compared to those who were not colonized. The laboratory cost of surveillance cultures during the study period was $58,425.
CONCLUSIONS:: The rate of colonization with AROs at transfer was low particularly in infants < 7 days old. Future studies should examine the safety of targeted surveillance strategies focused on older infants.
Theodore Macnow; Dana Oʼtoole; Patricia Delamora; Meghan Murray; Kristina Rivera; Susan Whittier; Barbara Ross; Stephen Jenkins; Lisa Saiman; Jennifer Duchon
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-6-27
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  -     ISSN:  1532-0987     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-7-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1. Department of Pediatrics, Columbia University Medical Center, New York, NY, USA 2. Department of Pediatrics, Cornell University, New York, NY, USA 3. Columbia University School of Nursing, New York, NY, USA 4. Department of Pathology, Columbia University Medical Center, New York, NY, USA 5. Department of Clinical Microbiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA 6. Department of Infection Prevention and Control, New York-Presbyterian Hospital, New York, NY, USA 7. Department of Pathology, Weill Cornell Medical Center, New York, NY, USA 8. Department of Clinical Microbiology, NewYork-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA.
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