扩大新生儿重症监护病房（NICU）的抗菌药物管理策略：手术部位感染的管理、围手术期预防用药以及培养阴性败血症。
Expanding antimicrobial stewardship strategies for the NICU: Management of surgical site infections, perioperative prophylaxis, and culture negative sepsis.
机构信息
Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA; Department of Infection Prevention and Control, NewYork -Presbyterian Hospital, New York, NY, USA.
Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA; Department of Infection Prevention and Control, NewYork -Presbyterian Hospital, New York, NY, USA.
出版信息
Semin Perinatol. 2020 Dec;44(8):151327. doi: 10.1016/j.semperi.2020.151327. Epub 2020 Oct 13.
OBJECTIVE
To review antibiotic stewardship strategies for neonatal intensive care units (NICU) in the areas of management of surgical site infections, perioperative prophylaxis and culture negative late onset sepsis.
FINDING
Review of local microbiology, stratification of surgical procedures by risk of contamination of the surgical site, and adherence to evidence-based principles of perioperative antibiotic administration (targeted therapy, effective dosing, appropriate timing and limiting duration post-operatively) can help to minimize unnecessary antibiotic use for neonatal surgery. Creating a late onset sepsis case definition, appropriate collection and interpretation of blood cultures, and instituting antibiotic time-outs can minimize the overuse of antibiotics for culture negative sepsis.
CONCLUSION
Effective implementation of these antimicrobial stewardship strategies in the NICU can reduce unnecessary antimicrobial use and limit the emergence of resistant pathogens.
目的
综述新生儿重症监护病房（NICU）在外科部位感染、围手术期预防和培养阴性晚发性败血症管理方面的抗生素管理策略。
发现
对局部微生物学的审查、对手术部位污染风险的手术程序进行分层，以及遵循围手术期抗生素使用的循证原则（靶向治疗、有效剂量、适当的时机和术后限制时间）有助于减少新生儿手术中不必要的抗生素使用。制定晚发性败血症病例定义、适当采集和解释血培养结果，并实施抗生素暂停，可以减少培养阴性败血症中抗生素的过度使用。
结论
在 NICU 中有效地实施这些抗菌药物管理策略可以减少不必要的抗菌药物使用，并限制耐药病原体的出现。
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