Selective use of vancomycin to prevent coagulase-negative staphylococcal nosocomial bacteremia in high risk very low birth weight infants
Selective use of vancomycin to prevent coagulase-negative staphylococcal nosocomial bacteremia in high risk very low birth weight infants
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DOI：
10.1097/00006454-199803000-00002
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发表时间：
1998-03-01
影响因子：
3.6
通讯作者：
Brown, EG
中科院分区：
文献类型：
--
作者：
Baier, RJ;Bocchini, JA;Brown, EG
Objective.确定万古霉素添加到肠外营养（PN）液中是否可以预防极低出生体重新生儿的医院感染，以及哪些婴儿将从腹泻中获益最多。双盲，随机对照研究。设置和研究人群。在三级新生儿重症监护病房接受PN的极低出生体重儿。38名有或没有中心血管导管的婴儿被随机分为两组，一组不接受任何药物治疗，另一组在婴儿需要PN的时间内在PN中加入25 μ g/ml万古霉素。PN中添加25 μ g/ml万古霉素可预防接受PN的极低出生体重儿的菌血症。PN期间凝固酶阴性葡萄球菌（CONS）菌群（定义为从两种阳性血培养物中分离出相同微生物）数量显著减少（5 vs. 0; P = 0.037），菌群和真菌血症总数显著减少（9 vs. 1; P = 0.036）。接受万古霉素治疗的婴儿的总住院天数（108 +/- 13 vs. 76 +/- 6; P = 0.039）减少。出生体重为
Objective. To determine whether vancomycin added to parental nutrition (PN) fluids could prevent nosocomial infections in very low birth weight newborns and which infants would benefit most from prophylaxis.Design. Double blind, randomized controlled study.Setting and study population. Very low birth weight infants receiving PN in a tertiary neonatal intensive care unit.Methods. Thirty-eight infants with and without central vascular catheters were randomized to receive no medication or 25 mu g/ml vancomycin added to PN for the duration of the infant's PN requirements.Results. The addition of 25 mu g/ml vancomycin to PN prevented bacteremia in very low birth weight infants receiving PN. There was a significant reduction in the number of coagulase-negative staphylococcal (CONS) bacteremias (defined as isolation of the same organism from two positive blood cultures) during PN (5 vs. 0; P = 0.037) as well as the total number of bacteremias and fungemias (9 vs. 1; P = 0.036). The total number of hospital days (108 +/- 13 vs. 76 +/- 6; P = 0.039) were reduced in infants receiving vancomycin. Infants with birth weights of