北美四级新生儿病房细菌和真菌感染的流行病学

Epidemiology of bacterial and fungal infections among level IV neonatal units in North America.

作者信息

Nishihara Yo, Zaniletti Isabella, Zenge Jeanne, Weikel Blair, Parker Sarah, Murthy Karna, Padula Michael A, Grover Theresa

机构信息

Section of Neonatology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.

Children's Hospitals Neonatal Consortium, Dover, DE, USA.

出版信息

J Perinatol. 2025 Jun 20. doi: 10.1038/s41372-025-02337-7.

DOI:10.1038/s41372-025-02337-7

PMID:40542124

Abstract

BACKGROUND

Neonatal infections cause significant morbidity and mortality. A comprehensive analysis of bloodstream infections (BSI), urinary tract infections (UTI) and meningitis across level IV neonatal intensive care units (NICUs) is lacking.

METHODS

This retrospective cohort study utilized data from the Children's Hospitals Neonatal Database (CHND) between January 2011 to December 2022. Patients with positive blood, urine, and cerebrospinal fluid (CSF) cultures were assessed. BSI trends across five geographic zones and a 10-year trend were studied.

RESULTS

Of 172,921 patients, 15,541 (9.0%) had a culture-positive BSI, UTI, and/or meningitis. Within the 18,281 positive cultures (9794 BSI, 7097 UTI and 1390 CSF), 21,919 pathogens were identified. Infection rates were inversely related to gestational age. Pathogen distribution varied across regions, and over 10 years, Coagulase negative Staphylococcus declined, while E. coli and S. aureus proportions increased.

CONCLUSION

Understanding infection trends in level IV NICUs can inform targeted preventive strategies and quality improvement initiatives.

摘要

背景

新生儿感染会导致严重的发病率和死亡率。目前缺乏对四级新生儿重症监护病房（NICU）中血流感染（BSI）、尿路感染（UTI）和脑膜炎的综合分析。

方法

这项回顾性队列研究利用了2011年1月至2022年12月期间儿童医院新生儿数据库（CHND）的数据。对血、尿和脑脊液（CSF）培养结果呈阳性的患者进行评估。研究了五个地理区域的BSI趋势以及10年趋势。

结果

在172,921名患者中，15,541名（9.0%）血培养、尿培养和/或脑脊液培养呈阳性。在18,281份阳性培养物中（9794份BSI、7097份UTI和1390份CSF），鉴定出21,919种病原体。感染率与胎龄呈负相关。病原体分布因地区而异，在10年期间，凝固酶阴性葡萄球菌减少，而大肠杆菌和金黄色葡萄球菌的比例增加。