Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany.
Department of Pediatric Pulmonology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.
J Hosp Infect. 2019 Jul;102(3):325-331. doi: 10.1016/j.jhin.2019.01.021. Epub 2019 Feb 1.
Preterm infants and critically ill neonates are predisposed to nosocomial infections as sepsis. Moreover, these infants acquire commensal bacteria, which might become potentially harmful. On-ward transmission of these bacteria can cause outbreaks.
To report the findings of a prospective surveillance of bacterial colonization and primary sepsis in preterm infants and neonates.
The results of the surveillance of bacterial colonization of the gut and the respiratory tract, targeting meticillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and Gram-negative bacteria from November 2016 to March 2018 were analysed. Bacterial colonization was compared to surveillance of sepsis.
Six-hundred and seventy-one patients were admitted and 87.0 % (N=584) of the patients were screened; 48.3% (N=282) of the patients screened were colonized with at least one of the bacteria included in the screening; 26.2% of them (N=74) had multi-drug-resistant strains. A total of 534 bacterial isolates were found. The most frequently found species were Escherichia coli, Enterobacter cloacae, Klebsiella oxytoca and Klebsiella pneumoniae. Three MRSA but no VRE were detected. The surveillance detected a K. pneumoniae cluster involving nine patients. There were 23 blood-culture-confirmed sepsis episodes; 60.9% (N=14) were caused by staphylococci. Gram-negative bacteria (one Klebsiella aerogenes and two E. cloacae) caused three sepsis episodes which were preceded by colonization with the respective isolates.
Surveillance of colonization provided a comprehensive overview of species and antibiotic resistance patterns. It allowed early detection of a colonization cluster. Knowledge of colonization and surveillance of sepsis is useful for guiding infection control measures and antibiotic treatment.
早产儿和危重新生儿易患败血症等医院获得性感染。此外，这些婴儿会获得共生菌，这些共生菌可能会变得具有潜在危害性。这些细菌的传播会导致爆发。
报告对早产儿和新生儿肠道和呼吸道细菌定植和原发性败血症进行前瞻性监测的结果。
分析了 2016 年 11 月至 2018 年 3 月对耐甲氧西林金黄色葡萄球菌（MRSA）、万古霉素耐药肠球菌（VRE）和革兰氏阴性菌的肠道和呼吸道细菌定植的监测结果。将细菌定植与败血症监测进行比较。
共收治 671 例患者，筛查 87.0%（N=584）的患者；筛查出的患者中有 48.3%（N=282）至少定植了一种筛查细菌；其中 26.2%（N=74）为多重耐药菌。共发现 534 株细菌分离株。最常见的菌种是大肠杆菌、阴沟肠杆菌、产酸克雷伯菌和肺炎克雷伯菌。共检出 3 株 MRSA，未检出 VRE。监测发现涉及 9 例患者的肺炎克雷伯菌群。血培养确诊败血症 23 例，其中 60.9%（N=14）由葡萄球菌引起。革兰氏阴性菌（1 株产气肠杆菌和 2 株阴沟肠杆菌）引起 3 例败血症，定植前均为相应分离株。
定植监测提供了对物种和抗生素耐药模式的全面概述。它可以早期发现定植群。定植和败血症监测的知识有助于指导感染控制措施和抗生素治疗。
