Frequency and Characteristics of Infections Caused by Extended-Spectrum Beta-Lactamase-Producing Organisms in Neonates: A Prospective Cohort Study

Abstract

This prospective cohort study was conducted to determine the frequency of infections caused by extended-spectrum beta-lactamase- (ESBL-) producing organisms, various bacteria producing ESBL, antibiotic susceptibility of these organisms, and the risk factors associated with these infections in a neonatal intensive care unit in a tertiary care hospital in North India. Of the 150 neonates enrolled in the study, 47 culture-positive neonates were included in the study cohort and were divided into two groups: ESBL-positive (8 neonates) and ESBL-negative (39 neonates) cohorts. Various organisms were isolated from 72 culture samples in these 47 neonates. Of these, 10 culture samples grew ESBL-positive organisms and 62 samples grew ESBL-negative organisms. The frequency of ESBL-producing organisms was found to be 5.3%. ESBL infection incidence densities were found to be 3.4 per 1000 patient-days. Klebsiella (60%) was the most common organism producing ESBL followed by Escherichia coli (30%) and Pseudomonas (10%). Eighty percent of the ESBL-producing organisms were sensitive to piperacillin-tazobactam. Risk factors found significant by univariate analysis (P < 0.05) were preterm, low birthweight, perinatal asphyxia, respiratory distress syndrome, anaemia, metabolic acidosis, prolonged mechanical ventilation (>7 days), length of hospitalization, length of level 3 stay, prior antibiotic use, central venous catheter duration, peripherally inserted central venous catheter duration, and total parenteral nutrition duration. Factors that retained significance in the logistic regression model were duration of hospital stay (adjusted OR: 0.958, CI: 0.920–0.997, and P value = 0.037) and gestational age (adjusted OR: 1.39, CI: 1.037–1.865, and P value = 0.028). There was no significant difference in the mortality between the two groups.

Prevalence and Antimicrobial Susceptibility of Extended Spectrum β-Lactamases (ESBL) Producing Escherichia coli and Klebsiella pneumoniae Isolates in a Tertiary Care Hospital in North-West India

“…Among the ESBL Klebsiella pneumoniae isolates highest occurrence was seen in pediatric patients 20/29(69.0%) and ICU patients 21/32(65.6%).Among the pediatric patients majority were neonates18/20(90.0%).The risk factors in these patients include low birth weight, prior exposure to antibiotics, use of invasive devices, underlying illness and length of hospital stay. (Vijayakanthi et al, 2013) The risk factors for acquiring ESBL Klebsiella pneumoniae in ICU patients was essentially the same as for ESBL E. coli.…”

Multidrug-resistant ESBL-producing Enterobacteriaceae and associated risk factors in community infants in Lebanon

“…There have been reports on the risk factors for infection or colonization by ESBL-producing bacteria in children from pediatric intensive care units and neonatal intensive care units; the risk factors identified include artificial nails of hospital staff, cockroach infestation as vectors [40,41], younger gestational age, low birth weight, prolonged mechanical ventilation, longer hospital stay, invasive devices, antibiotic use [42][43][44][45], and mother-to-child transmission [46].…”

Epidemiological Features of Nosocomial Bloodstream Infections in Pediatric Patients

“…Bu sonuç dünyadaki nKDİ eğiliminden farklılık göster-mektedir (7,(11)(12)(13)(14)(15)(16) (17,18). Dirençli patojenlerin neden olduğu infeksiyonlar özel-likle yenidoğanlarda ve YBÜ'lerde yaygın olarak görülmekte-dir ve yüksek morbidite ve mortaliteye neden olmaktadır.…”