Narendra Pal Singh1, Debapriya Das Choudhury1, Kavita Gupta2, Sumit Rai3, Prerna Batra4, Vikas Manchanda5, Rituparna Saha1, I R Kaur1. 1. Department of Microbiology, UCMS & GTB Hospital, New Delhi, India. 2. Department of Microbiology, UCMS & GTB Hospital, New Delhi, India. Electronic address: drkavitagupta2010@gmail.com. 3. Department of Microbiology, VMMC & Safdarjang Hospital, New Delhi, India. 4. Department of Paediatrics, UCMS & GTB Hospital, New Delhi, India. 5. Maulana Azad Medical College, New Delhi, India.
Abstract
BACKGROUND: With the emergence of carbapenem-resistant isolates, the therapeutic alternatives have become limited. Various factors are responsible for carbapenem-resistant Enterobacteriaceae (CRE) gut colonization. This study was conducted to determine predictors for CRE gut colonization in neonates who were hospital delivered and admitted in a neonatal intensive care unit (NICU). METHODS: Three rectal swabs were collected from 300 hospital-delivered and NICU-admitted neonates (likely to stay for >3 days). The data collected for the possible risk factors for CRE gut colonization were namely mode of delivery, prolonged rupture of membrane >18 hours, period of gestation, birth weight, meconium-stained liquor, ventilation, intravenous catheter, nasogastric (NG) tube, NG feeding, breastfeeding, katori spoon feeding, top feeding, expressed breastmilk, antibiotics administration, and duration of hospitalization. P < .05 was considered as statistically significant. RESULTS: A total of 26 cases of CRE were isolated from 300 neonates. Statistically significant risk factors were found to be NG tube, breastfeeding, NG feeding, top feeding, expressed breastmilk, ventilation, antibiotic administration, and duration of hospitalization. Top feeding and antibiotics administration were identified as 2 independent risk factors by multiple logistic regression. CONCLUSIONS: Active surveillance of cultures from hospitalized patients and implementation of preventive efforts can reduce the risk of CRE.
BACKGROUND: With the emergence of carbapenem-resistant isolates, the therapeutic alternatives have become limited. Various factors are responsible for carbapenem-resistant Enterobacteriaceae (CRE) gut colonization. This study was conducted to determine predictors for CRE gut colonization in neonates who were hospital delivered and admitted in a neonatal intensive care unit (NICU). METHODS: Three rectal swabs were collected from 300 hospital-delivered and NICU-admitted neonates (likely to stay for >3 days). The data collected for the possible risk factors for CRE gut colonization were namely mode of delivery, prolonged rupture of membrane >18 hours, period of gestation, birth weight, meconium-stained liquor, ventilation, intravenous catheter, nasogastric (NG) tube, NG feeding, breastfeeding, katori spoon feeding, top feeding, expressed breastmilk, antibiotics administration, and duration of hospitalization. P < .05 was considered as statistically significant. RESULTS: A total of 26 cases of CRE were isolated from 300 neonates. Statistically significant risk factors were found to be NG tube, breastfeeding, NG feeding, top feeding, expressed breastmilk, ventilation, antibiotic administration, and duration of hospitalization. Top feeding and antibiotics administration were identified as 2 independent risk factors by multiple logistic regression. CONCLUSIONS: Active surveillance of cultures from hospitalized patients and implementation of preventive efforts can reduce the risk of CRE.
Authors: Suzan S Asfour; Faisal A Alaklobi; Adli Abdelrahim; Muhammed Y Taha; Raneem S Asfour; Thanaa M Khalil; Mountasser M Al-Mouqdad Journal: J Pediatr Pharmacol Ther Date: 2022-02-09