Extended-spectrum β-lactamase-producing Klebsiella pneumoniae in the neonatal intensive care unit: Does vancomycin play a role?

被引:18
|
作者
Somily, Ali M. [1 ]
Alsubaie, Sarah S. [2 ]
BinSaeed, Abdulaziz A. [3 ]
Torchyan, Armen A. [3 ]
Alzamil, Fahad A. [2 ]
Al-Aska, AbdulKarim I. [4 ]
Al-Khattaf, Fatimah S. [5 ]
Khalifa, Lyla A. [5 ]
Al-Thawadi, Sahar I. [6 ]
Alaidan, Alwaleed A. [6 ]
Al-Ahdal, Mohammed N. [6 ]
Al-Qahtani, Ahmed A. [6 ]
Murray, Thomas S. [7 ]
机构
[1] King Saud Univ, Coll Med, Dept Pathol, Riyadh 11461, Saudi Arabia
[2] King Saud Univ, Coll Med, Dept Pediat, Riyadh 11461, Saudi Arabia
[3] King Saud Univ, Coll Med, Dept Family & Community Med, Riyadh 11461, Saudi Arabia
[4] King Saud Univ, Coll Med, Dept Med, Riyadh 11461, Saudi Arabia
[5] King Saud Univ, Coll Med, Dept Infect Control, Riyadh 11461, Saudi Arabia
[6] King Faisal Specialist Hosp & Res Ctr, Dept Infect & Immun, Res Ctr, Riyadh 11211, Saudi Arabia
[7] Yale Univ, Sch Med, Dept Lab Med, New Haven, CT 06510 USA
关键词
Antibiotics; Colonization; Infection; Outbreak; Saudi Arabia; MOLECULAR EPIDEMIOLOGY; RISK-FACTORS; NOSOCOMIAL INFECTIONS; OUTBREAK; ENTEROBACTERIACEAE; COLONIZATION; IDENTIFICATION; NURSERY; INFANTS; CLUSTER;
D O I
10.1016/j.ajic.2013.09.028
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Extended-spectrum beta-lactamase (ESBL)-producing Klebsiella species cause worldwide problems in neonatal intensive care units (NICUs). This study aimed to determine possible risk factors for infection or colonization with ESBL-producing Klebsiella pneumoniae (ESBLKp) during an outbreak in the NICU. Methods: A retrospective cohort study was conducted among neonates admitted to the NICU of a teaching hospital in Riyadh, Saudi Arabia, during an outbreak of ESBLKp from April to July 2008. The incidence density ratio was calculated to determine possible predictors of ESBLKp colonization or infection. Results: During 2,265 person-days of follow-up of 118 neonates, 4 became infected, and 8 were colonized with ESBLKp. Univariate analyzes revealed that, among 14 neonates who were treated with vancomycin, 9 (64.3%) developed infection or colonization with ESBLKp, whereas, among 104 neonates who were not treated with vancomycin, 3 (2.9%) were affected, with an incidence density ratio of 4.22 (95% confidence interval: 1.47-5.15). Parenteral feeding and mechanical ventilation were found to be marginally significant risk factors. Conclusion: Treatment with vancomycin appears to be a risk factor for infection or colonization with ESBLKp in the NICU setting. Copyright (C) 2014 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:277 / 282
页数:6
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