Orman Aysen, Celik Yalcin, Evik Guliz, Ersöz Gulden, Kuyucu Necdet, Ozmen Berfin Ozgokce
Division of Neonatology, Department of Pediatrics, Mersin University School of Medicine, Mersin 33110, Türkiye.
Department of Clinical Microbiology and Infectious Diseases, Mersin University School of Medicine, Mersin 33110, Türkiye.
Children (Basel). 2023 Jan 19;10(2):187. doi: 10.3390/children10020187.
Serial perirectal swabs are used to identify colonization of multidrug-resistant bacteria and prevent spread. The purpose of this study was to determine colonization with carbapenem-resistant Enterobacterales (CRE) and vancomycin-resistant Enterococci (VRE). An additional purpose was to establish whether sepsis and epidemic associated with these factors were present in the neonatal intensive care unit (NICU), to which infants with hospital stays exceeding 48 h in an external healthcare center NICU were admitted. Perirectal swab samples were collected in the first 24 h by a trained infection nurse using sterile cotton swabs moistened with 0.9% NaCl from patients admitted to our unit after hospitalization exceeding 48 h in an external center. The primary outcome was positivity in perirectal swab cultures, and the secondary outcomes were whether this caused invasive infection and significant NICU outbreaks. A total of 125 newborns meeting the study criteria referred from external healthcare centers between January 2018 and January 2022 were enrolled. Analysis revealed that CRE constituted 27.2% of perirectal swab positivity and VRE 4.8%, and that one in every 4.4 infants included in the study exhibited perirectal swab positivity. The detection of colonization by these microorganisms, and including them within the scope of surveillance, is an important factor in the prevention of NICU epidemics.
连续进行直肠拭子检查用于识别耐多药细菌的定植并防止其传播。本研究的目的是确定耐碳青霉烯类肠杆菌科细菌（CRE）和耐万古霉素肠球菌（VRE）的定植情况。另一个目的是确定新生儿重症监护病房（NICU）是否存在与这些因素相关的败血症和疫情，入住外部医疗中心NICU且住院时间超过48小时的婴儿被收治到该病房。在婴儿于外部中心住院超过48小时后入住我们科室时，由一名经过培训的感染护士在最初24小时内使用用0.9%氯化钠湿润的无菌棉拭子采集直肠拭子样本。主要结局是直肠拭子培养阳性，次要结局是这是否导致侵袭性感染和NICU内的重大疫情爆发。2018年1月至2022年1月期间，共有125名符合研究标准的新生儿从外部医疗中心转诊而来并被纳入研究。分析显示，CRE占直肠拭子阳性的27.2%，VRE占4.8%，且纳入研究的每4.4名婴儿中就有1名直肠拭子呈阳性。检测这些微生物的定植情况并将其纳入监测范围是预防NICU疫情的一个重要因素。
