Bär Alisa, Schmitt-Grohé Sabina, Held Jürgen, Lubig Julia, Hanslik Gregor, Fahlbusch Fabian B, Reutter Heiko, Woelfle Joachim, van der Donk Adriana, Schleier Maria, Hepp Tobias, Morhart Patrick
Division of Neonatology and Pediatric Intensive Care, Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander-University of Erlangen-Nuernberg, Loschgestraße 15, 91054 Erlangen, Germany.
Division of Allergology, Pulmonology and Mucoviscidosis, Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander University of Erlangen-Nuernberg, Loschgestraße 15, 91054 Erlangen, Germany.
Antibiotics (Basel). 2023 Jan 17;12(2):189. doi: 10.3390/antibiotics12020189.
(1) Background: Since 2013, weekly screening for multidrug-resistant Gram-negative (MDRGN) bacteria has been performed in German neonatal intensive care units (NICU). National guidelines recommend considering these colonization analyses for antibiotic treatment regimens. Our retrospective single center study provides insight into the clinical dichotomy of bacterial colonization and infection rates in neonates. (2) Methods: We analyzed microbiological data of neonates admitted to our tertiary level NICU over nine years. Colonization with MDRGN/ (SERMA) was compared to microbiological findings in sepsis and pneumonia. (3) Results: We analyzed 917 blood and 1799 tracheal aspirate samples. After applying criteria from the Nosocomial Infection Surveillance for Neonates (NEO-KISS), we included 52 and 55 cases of sepsis and pneumonia, respectively; 19.2% of sepsis patients and 34.5% of pneumonia patients had a prior colonization with MDRGN bacteria or SERMA. In these patients, sepsis was not attributable to MDRGN bacteria yet one SERMA, while in pneumonias, ten MDRGN bacteria and one SERMA were identified. We identified late-onset pneumonia and cesarean section as risk factors for MDRGN/SERMA acquisition. (4) Conclusions: Colonization screening is a useful tool for hygiene surveillance. However, our data suggest that consideration of colonization with MDRGN/SERMA might promote extensive use of last resort antibiotics in neonates.
(1) 背景：自2013年以来，德国新生儿重症监护病房（NICU）每周都会对耐多药革兰氏阴性（MDRGN）菌进行筛查。国家指南建议在制定抗生素治疗方案时考虑这些定植分析。我们的回顾性单中心研究深入探讨了新生儿细菌定植与感染率的临床差异。(2) 方法：我们分析了九年间入住我们三级NICU的新生儿的微生物学数据。将MDRGN/（SERMA）定植情况与败血症和肺炎的微生物学检查结果进行比较。(3) 结果：我们分析了917份血液样本和1799份气管吸出物样本。应用新生儿医院感染监测（NEO-KISS）的标准后，我们分别纳入了52例败血症病例和55例肺炎病例；19.2%的败血症患者和34.5%的肺炎患者之前定植有MDRGN菌或SERMA。在这些患者中，败血症并非由MDRGN菌引起，而是由一种SERMA引起，而在肺炎患者中，鉴定出了10种MDRGN菌和1种SERMA。我们确定迟发性肺炎和剖宫产是获得MDRGN/SERMA的危险因素。(4) 结论：定植筛查是卫生监测的有用工具。然而，我们的数据表明，考虑MDRGN/SERMA定植情况可能会促使在新生儿中广泛使用最后手段抗生素。
