Department of Neonatology, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore.
Department of Neonatology, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
Int J Infect Dis. 2023 Nov;136:11-13. doi: 10.1016/j.ijid.2023.08.016. Epub 2023 Aug 28.
In this study, we aim to describe the patterns of early-life surface colonization with multi-drug resistant (MDR) organisms (MDROs) among newborns admitted to the neonatal intensive care unit (NICU).
We conducted a retrospective descriptive study of infants with culture-positive external ear surface swabs performed immediately after admission to our NICU from January 1, 2017 - December 31, 2021. Clinical characteristics, culture and antibiotic susceptibility data were extracted from the department data collection and hospital electronic databases.
A total of 314 infants were included - median 34 weeks gestation (interquartile range [IQR] 30, 38) and median birthweight 2147 g (IQR 1470, 2875). Of the 379 bacterial isolates obtained, 259 (68.3%) were gram-negative with Escherichia coli (149/379, 39.3%) and Klebsiella spp (57/379, 15.0%) the most common gram-negatives isolated. MDROs accounted for 17.4% (45/259) of gram-negative isolates. There was no methicillin-resistant Staphylococcus aureus (0/22 isolates) or vancomycin-resistant Enterococcus (0/68) detected among isolates tested. A total of 27 (8.6%) infants developed bacteremia, of which 21/27 (77.8%) had concordant bacteria isolated from surface cultures, with identical resistance patterns, and 4/21 (19.0%) isolates were MDROs.
In our setting where gram-negative bacteria accounted for a high proportion of initial colonization, MDR gram-negatives accounted for up to 17% of colonizing gram-negative bacteria detected.
本研究旨在描述新生儿重症监护病房（NICU）新生儿早期多药耐药（MDR）定植模式。
我们对 2017 年 1 月 1 日至 2021 年 12 月 31 日期间在我院 NICU 入院后立即进行的外耳表面培养阳性的婴儿进行了回顾性描述性研究。从科室数据采集和医院电子数据库中提取临床特征、培养和抗生素药敏数据。
共纳入 314 例婴儿-中位胎龄 34 周（四分位距 [IQR] 30，38）和中位出生体重 2147g（IQR 1470，2875）。在获得的 379 株细菌分离株中，259 株（68.3%）为革兰氏阴性菌，其中大肠埃希菌（149/379，39.3%）和克雷伯菌属（57/379，15.0%）最为常见。MDROs 占革兰氏阴性菌分离株的 17.4%（45/259）。在所检测的分离株中未发现耐甲氧西林金黄色葡萄球菌（0/22 株）或万古霉素耐药肠球菌（0/68 株）。共有 27 例（8.6%）婴儿发生菌血症，其中 27 例（77.8%）从表面培养物中分离出与菌血症相同的细菌，耐药模式相同，4 例（19.0%）分离株为 MDROs。
在我们的研究环境中，革兰氏阴性菌占初始定植的很大比例，MDR 革兰氏阴性菌占定植革兰氏阴性菌的 17%左右。
