High frequency of multidrug-resistant gram-negative rods in 2 neonatal intensive care units in the Philippines.
High frequency of multidrug-resistant gram-negative rods in 2 neonatal intensive care units in the Philippines.
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DOI：
10.1086/597512
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发表时间：
2009-06
影响因子：
4.5
通讯作者：
Hamer DH
中科院分区：
文献类型：
--
作者：
Litzow JM;Gill CJ;Mantaring JB;Fox MP;MacLeod WB;Mendoza M;Mendoza S;Scobie R;Huskins CW;Goldman DA;Hamer DH
Though hospital-acquired infections appear to be a growing threat to newborn survival in the developing world, the epidemiology of this problem remains poorly characterized. Over a 10 month period, we conducted prospective longitudinal surveillance for colonization and bloodstream infections with Gram-negative rods (GNRs) among all infants admitted to the two largest neonatal intensive care units (NICUs) in Manila, the Philippines, determined antibiotic sensitivities, and calculated adjusted odds ratios (OR) for factors for bacteremia using multivariate logistic regression. Among 1,831 neonates enrolled over a 10-month period, 1017 (55%) became newly colonized and 358 (19.6%) became bacteremic with a resistant GNR, most commonly Klebsiella species, Enterobacter species, Acinetobacter species, and Pseudomonas aeruginosa. The proportion of invasive isolates with antibiotic resistance was: imipenem 20%, trimethoprim-sulfamethoxazole 41%, amikacin 52%, ampicillin/sulbactam 63%, ceftazidime 67%, and tobramycin 80%. Factors significantly associated with increased risk of bacteremia were mechanical ventilation and prematurity. Additionally, colonization with a resistant GNR was an independent risk for bacteremia. (OR 1.4, 95% CI 1.0 – 1.9) Colonization with a resistant GNR was an independent risk factor for sepsis. If our data are typical, the unusually high intensity of colonization pressure and disease with multidrug-resistant GNRs at these two NICUs constitutes an emerging health care crisis in the developing world. Improved infection control methods are therefore critically needed in developing country settings.
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影响因子：
--
作者：
Jeena, P;Thompson, E;Sturm, A
通讯作者：
Sturm, A
影响因子：
168.9
作者：
de Man, P;Verhoeven, BAN;van den Anker, JN
通讯作者：
van den Anker, JN
影响因子：
11.8
作者：
Gill, Christopher J.;Mantaring, Jose B. V.;Hamer, Davidson H.
通讯作者：
Hamer, Davidson H.
DOI：
10.1038/sj.jp.7211283
发表时间：
2005-05-01
期刊：
Journal of perinatology : official journal of the California Perinatal Association
影响因子：
--
作者：
Darmstadt, Gary L;Nawshad Uddin Ahmed, A S M;Santosham, Mathuram
通讯作者：
Santosham, Mathuram
影响因子：
3.6
作者：
Macias, AE;Munoz, JM;Ponce-De-Leon, S
通讯作者：
Ponce-De-Leon, S