First name
Yu-Hui
Last name
Ferng

Title

Infant Colonization with Methicillin-Resistant Staphylococcus aureus or Vancomycin-Resistant Enterococci Preceding Neonatal Intensive Care Unit Discharge.

Year of Publication

2017

Number of Pages

Date Published

2017 Mar 01

ISSN Number

2048-7207

Abstract

<p>Rates of colonization with methicillin-resistant Staphylococcus aureus (MRSA) and/or vancomycin-resistant enterococci (VRE) were determined for 1320 infants within 7 days of neonatal intensive care unit discharge. Overall, 4% and 1% of the infants were colonized with MRSA or VRE, respectively. Predictors identified in fixed-effects models were surgery during hospitalization (for MRSA colonization) and prolonged antimicrobial treatment (for VRE colonization).</p>

DOI

10.1093/jpids/pix003

Alternate Title

J Pediatric Infect Dis Soc

PMID

28339914
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Title

Multicenter Study of Hand Carriage of Potential Pathogens by Neonatal ICU Healthcare Personnel.

Year of Publication

2015

Number of Pages

276-9

Date Published

2015 Sep

ISSN Number

2048-7207

Abstract

<p>A multicenter surveillance study was performed to determine the rates of hand carriage of potential pathogens among healthcare personnel in four neonatal intensive care units. Staphylococcus aureus, enterococci, and gram-negative bacilli were recovered from 8%, 3%, and 2% of 1000 hand culture samples, respectively.</p>

DOI

10.1093/jpids/piu022

Alternate Title

J Pediatric Infect Dis Soc

PMID

26336605
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Title

Surgical site infections in a longitudinal cohort of neonatal intensive care unit patients.

Year of Publication

2016

Number of Pages

300-5

Date Published

2016 Apr

ISSN Number

1476-5543

Abstract

<p><strong>OBJECTIVE: </strong>To estimate the incidence and identify risk factors for surgical site infections (SSIs) among infants in the neonatal intensive care unit (NICU).</p>

<p><strong>STUDY DESIGN: </strong>A prospective cohort study of infants undergoing surgical procedures from May 2009 to April 2012 in three NICUs was performed. SSI was identified if documented by an attending neonatologist and treated with intravenous antibiotics. Independent risk factors were identified using logistic regression, adjusting for NICU.</p>

<p><strong>RESULT: </strong>A total of 902 infants underwent 1346 procedures and experienced 60 SSIs (incidence: 4.46/100 surgeries). Risk factors for SSIs included younger chronological age (odds ratio (OR) 1.03 per day decrease, 95% confidence interval (CI) 1.01, 1.04), lower gestational age (OR 1.09 per week decrease, CI 1.02, 1.18), male sex (OR 1.17, CI 1.04, 1.34) and use of central venous catheter (OR 4.40, CI 1.19, 9.62). Only 43% had surgical site cultures obtained and Staphylococcus aureus was most commonly isolated.</p>

<p><strong>CONCLUSION: </strong>SSIs complicated 4.46% of procedures performed in the NICU. Although few modifiable risk factors for SSIs were identified, future efforts should focus on evaluating the impact of current prevention strategies on the incidence of neonatal SSI.</p>

DOI

10.1038/jp.2015.191

Alternate Title

J Perinatol

PMID

26658124
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Title

Colonization With Antimicrobial-Resistant Gram-Negative Bacilli at Neonatal Intensive Care Unit Discharge.

Year of Publication

2016

Number of Pages

Date Published

2016 Mar 28

ISSN Number

2048-7207

Abstract

<p>In multivariable analysis, prolonged antimicrobial treatment was a predictor of infant colonization with antimicrobial-resistant Gram-negative bacilli within 7 days of discharge from a neonatal intensive care unit.</p>

<p><strong>BACKGROUND: </strong>The epidemiology of the colonization of infants with antimicrobial-resistant Gram-negative bacilli (GNB) at discharge from the neonatal intensive care unit (NICU) is not well understood.</p>

<p><strong>METHODS: </strong>A multicenter study in which rectal surveillance samples for culture were obtained at NICU discharge from infants hospitalized ≥14 days was performed. Factors associated with colonization with GNB resistant to gentamicin, third/fourth-generation cephalosporin agents, or carbapenem agents were assessed by using a fixed-effects model.</p>

<p><strong>RESULTS: </strong>Of these infants, 9% (119 of 1320) were colonized with ≥1 antimicrobial-resistant GNB. Prolonged treatment (≥10 days) with meropenem or third/fourth-generation cephalosporin agents or treatment for ≥5 days with a β-lactam/β-lactamase combination agent were associated with an increased risk of colonization with GNB resistant to gentamicin. Surgery and ≥5 days of treatment with third/fourth-generation cephalosporin agents, a β-lactam/β-lactamase combination agent, or metronidazole were associated with an increased risk of colonization with GNB resistant to third/fourth-generation cephalosporin agents. Female sex and prolonged treatment (≥10 days) with meropenem were associated with colonization with GNB resistant to carbapenem agents.</p>

<p><strong>CONCLUSIONS: </strong>Prolonged treatment with broad-spectrum antibiotics was associated with the colonization of infants with antimicrobial-resistant GNB within 7 days of NICU discharge. These findings suggest the potential for dissemination of resistant GNB from colonized infants to other NICUs, the community, or pediatric long-term care facilities. Antimicrobial stewardship efforts aimed at improving appropriate antibiotic use could have a beneficial effect on the emergence of antimicrobial-resistant GNB in the NICU population.</p>

DOI

10.1093/jpids/piw014

Alternate Title

J Pediatric Infect Dis Soc

PMID

27021036
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