先天性膈疝新生儿的抗生素暴露与感染流行病学
Antibiotic exposure and infection epidemiology among newborns with congenital diaphragmatic hernia.
作者信息
Flohr Sabrina J, Mathew Leny, Hedrick Holly L, Rintoul Natalie E, Metjian Talene A, Swami Sanjeev K, Gerber Jeffrey S, Medoro Alexandra K, Flannery Dustin D
机构信息
Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Pennsylvania, PA, USA.
Division of Pediatric General, Thoracic, and Fetal Surgery, Children's Hospital of Philadelphia, Pennsylvania, PA, USA.
出版信息
J Perinatol. 2025 Aug 18. doi: 10.1038/s41372-025-02389-9.
OBJECTIVE
To describe infection epidemiology and measure antibiotic utilization among a large cohort of newborns with congenital diaphragmatic hernia (CDH).
STUDY DESIGN
Retrospective observational study including inborn newborns with CDH at a level IV referral center (free-standing children's hospital with special delivery unit) and two associated level III birth centers who underwent active care and survived to NICU admission, born 1/2013-11/2022 with available disposition.
RESULTS
Of 381 newborns with CDH who were admitted to the NICU, 370 (97.1%) received antibiotics. There were 137 (36.1%) newborns with a positive bacterial culture from any source; 78/381 (20.4%) had a positive culture from blood, urine, or spinal fluid.
CONCLUSION
Nearly all newborns with CDH at our center received antibiotics during their hospitalization, but the majority did not have a positive bacterial culture result, indicating opportunities exist for antibiotic stewardship among this population.
目的
描述先天性膈疝（CDH）一大群新生儿的感染流行病学情况，并衡量抗生素的使用情况。
研究设计
回顾性观察研究，纳入在一家四级转诊中心（设有特殊分娩单元的独立儿童医院）以及两个相关三级分娩中心出生且患有CDH、接受积极治疗并存活至入住新生儿重症监护病房（NICU）的活产新生儿，这些新生儿于2013年1月至2022年11月出生且有可用的处置信息。
结果
在入住NICU的381例CDH新生儿中，370例（97.1%）接受了抗生素治疗。有137例（36.1%）新生儿从任何来源获得细菌培养阳性结果；78/381例（20.4%）血液、尿液或脑脊液培养呈阳性。
结论
我们中心几乎所有患有CDH的新生儿在住院期间都接受了抗生素治疗，但大多数患儿细菌培养结果为阴性，这表明在这一人群中存在抗生素管理的机会。
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