Bloodstream infections in a neonatal intensive-care unit: 12 years' experience with an antibiotic control program
Bloodstream infections in a neonatal intensive-care unit: 12 years' experience with an antibiotic control program
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DOI：
10.1086/501619
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发表时间：
1999-04-01
影响因子：
4.5
通讯作者：
Ayers, LW
中科院分区：
文献类型：
--
作者：
Cordero, L;Sananes, M;Ayers, LW
目的：评估在12年期间，在一致的抗生素治疗方案到位的情况下，革兰氏阳性球菌（GPC）、革兰氏阴性杆菌（GNB）和真菌血流感染（BSI）的患病率;评估这些抗生素政策与治疗、细菌或真菌耐药性的出现以及感染爆发或流行病的发生相关的疗效。研究设计：方法：对1986年至1991年和1992年至1997年出生的363名婴儿的人口统计学、临床和细菌学信息进行分析，这些婴儿共发生433例血培养证实的BSI。早发性BSI定义为出生后48小时内发现的感染，晚发性BSI定义为出生后48小时内发现的感染。疑似早发性BSI用氨苄青霉素和庆大霉素治疗，疑似迟发性BSI用万古霉素和庆大霉素治疗。抗生素的基础上改变微生物的抗菌药物sensitivity.Results：早发性BSI注意到在52的21,336活产和40的20,402活产在1986年至1991年和1992年至1997年，分别。GPC（83%由B组链球菌[GBS]引起）约占早发BSI病例的一半，其余病例为GN B（68%为肠杆菌属）。早发性GBS从24例下降到11例（P=.04），晚发性BSI从111例增加到230例（P
OBJECTIVE: To assess the prevalence of gram-positive coccal (GPC), gram-negative bacillary (GNB), and fungal bloodstream infections (BSIs) during a 12-year period in which a consistent antibiotic treatment protocol was in place; to evaluate the efficacy of these antibiotic policies in relation to treatment, to the emergence of bacterial or fungal resistance, and to the occurrence of infection outbreaks or epidemics.STUDY DESIGN: Case series.METHODS: Demographic, clinical, and bacteriological information from 363 infants born during 1986 through 1991 and 1992 through 1997 who developed 433 blood-culture-proven BSIs was analyzed. Early-onset BSIs were defined as those infections discovered within 48 hours of birth, and late-onset BSIs as those that occurred thereafter. Suspected early-onset BSIs were treated with ampicillin and gentamicin, and suspected late-onset BSIs with vancomycin and gentamicin. Antibiotics were changed on the basis of organism antimicrobial susceptibility.RESULTS: Early-onset BSIs were noted in 52 of 21,336 live births and 40 of 20,402 live births during 1986 through 1991 and 1992 through 1997, respectively. GPC (83% due to group B streptococcus [GBS]) accounted for approximately one half of early-onset BSI cases and GNB (68% Enterobacteriaceac) for the remainder. Early-onset GBS declined from 24 to 11 cases (P=.04) and late-onset BSI increased from 111 to 230 cases (P