First name
David
Middle name
A
Last name
Paul

Title

Do infants in the neonatal intensive care unit diagnosed with urinary tract infection need a routine voiding cystourethrogram?

Year of Publication

2017

Number of Pages

1-6

Date Published

2017 Dec 20

ISSN Number

1476-4954

Abstract

<p><strong>OBJECTIVE: </strong>To determine if infants diagnosed with urinary tract infection (UTI) in the neonatal intensive care unit (NICU) require a routine voiding cystourethrogram (VCUG).</p>

<p><strong>STUDY DESIGN: </strong>Retrospective data analysis from three centers for infants admitted to the NICU born between 2000 and 2013 and diagnosed with UTI.</p>

<p><strong>RESULTS: </strong>One hundred twenty-six infants from three centers were diagnosed with UTI during their hospitalization. Renal ultrasound (RUS) was performed in 115 infants (91.2%), of which 69 (60%) were abnormal. Mild to moderate hydronephrosis or pelviectasis were the most common abnormalities identified (n = 34, 30%). There were 14 infants (12%) with severe abnormalities on RUS. VCUG was performed in 71 infants (56%), of which 3 (4%) were interpreted as abnormal with grade 2 vesicoureteral reflux (VUR) or less (two infants were with normal RUS and one infant was with abnormal RUS).</p>

<p><strong>CONCLUSIONS: </strong>More than 50% of infants with a UTI had an abnormal RUS but severe abnormalities were found only in 11% of infants. Only 4% of infants with UTI had VUR; none of these infants had severe VUR on VCUG. A routine VCUG after UTI in the NICU has a low yield and may be reserved for infants with severe or persistent abnormalities on RUS.</p>

DOI

10.1080/14767058.2017.1416352

Alternate Title

J. Matern. Fetal. Neonatal. Med.

PMID

29226740

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

Title

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

Year of Publication

2016

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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