Science and Research

Prospective surveillance of bacterial colonization and primary sepsis: findings of a tertiary neonatal intensive and intermediate care unit

BACKGROUND: Preterm infants and critically ill neonates are predisposed to nosocomial infections as sepsis. Moreover, these infants acquire commensal bacteria, which might become potentially harmful. On-ward transmission of these bacteria can cause outbreaks. AIM: To report the findings of a prospective surveillance of bacterial colonization and primary sepsis in preterm infants and neonates. METHODS: The results of the surveillance of bacterial colonization of the gut and the respiratory tract, targeting meticillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and Gram-negative bacteria from November 2016 to March 2018 were analysed. Bacterial colonization was compared to surveillance of sepsis. FINDINGS: Six-hundred and seventy-one patients were admitted and 87.0 % (N=584) of the patients were screened; 48.3% (N=282) of the patients screened were colonized with at least one of the bacteria included in the screening; 26.2% of them (N=74) had multi-drug-resistant strains. A total of 534 bacterial isolates were found. The most frequently found species were Escherichia coli, Enterobacter cloacae, Klebsiella oxytoca and Klebsiella pneumoniae. Three MRSA but no VRE were detected. The surveillance detected a K. pneumoniae cluster involving nine patients. There were 23 blood-culture-confirmed sepsis episodes; 60.9% (N=14) were caused by staphylococci. Gram-negative bacteria (one Klebsiella aerogenes and two E. cloacae) caused three sepsis episodes which were preceded by colonization with the respective isolates. CONCLUSIONS: Surveillance of colonization provided a comprehensive overview of species and antibiotic resistance patterns. It allowed early detection of a colonization cluster. Knowledge of colonization and surveillance of sepsis is useful for guiding infection control measures and antibiotic treatment.

  • Baier, C.
  • Pirr, S.
  • Ziesing, S.
  • Ebadi, E.
  • Hansen, G.
  • Bohnhorst, B.
  • Bange, F. C.

Keywords

  • Bacterial Infections/*epidemiology/microbiology
  • Carrier State/*epidemiology/microbiology
  • Disease Transmission, Infectious
  • *Epidemiological Monitoring
  • Gastrointestinal Tract/microbiology
  • Gram-Negative Bacteria/isolation & purification
  • Humans
  • Infant
  • Infant, Newborn
  • *Intensive Care Units, Neonatal
  • Methicillin-Resistant Staphylococcus aureus/isolation & purification
  • Prospective Studies
  • Respiratory System/microbiology
  • Sepsis/*epidemiology/microbiology
  • Tertiary Care Centers
  • Vancomycin-Resistant Enterococci/isolation & purification
  • Cluster
  • Colonization
  • Infection control
  • Neonatal intensive care unit
  • Preterm
  • Sepsis
Publication details
DOI: 10.1016/j.jhin.2019.01.021
Journal: J Hosp Infect
Pages: 325-331 
Number: 3
Work Type: Original
Location: BREATH
Disease Area: General Lung and Other
Partner / Member: MHH
Access-Number: 30716339
See publication on PubMed

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