Anucha Thatrimontrichai1, Nutchana Premprat2, Waricha Janjindamai3, Supaporn Dissaneevate4, Gunlawadee Maneenil5. 1. Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. tanucha@medicine.psu.ac.th. 2. Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. nutchanapp@yahoo.com. 3. Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. jwaricha@medicine.psu.ac.th. 4. Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. dsupapor@medicine.psu.ac.th. 5. Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. kookwadee@hotmail.com.
Abstract
INTRODUCTION: To identify the risks and outcomes for multidrug-resistant Gram-negative bacilli (MDRGNB) sepsis in neonates. METHODOLOGY: This was a retrospective case-case-control study between 1991 and 2016. The control group was selected from the same source records of all neonates with clinical or suspected sepsis but not culture-proven. RESULTS: The numbers of patients in the MDRGNB sepsis, non-MDRGNB sepsis, and control groups were 157, 88, and 218, respectively. MDRGNB sepsis was significantly associated with outborn infants [adjusted odds ratio (aOR) 2.08; p = 0.003] and infants who had a neurologic sequela (aOR 11.58; p = 0.04), lower gestational age (p = 0.03) or previous aminoglycoside use (aOR 2.43; p < 0.001) compared with the control group. Non-MDRGNB sepsis was associated with outborn infants (aOR 2.63; p < 0.001), and infants who had neurologic sequelae (aOR 48.25; p = 0.001) and previous cephalosporin use (aOR 6.28; p < 0.001) or cefoperazone plus sulbactam use (aOR 6.48; p = 0.02) compared with the control group. Case fatality (OR 3.63; p < 0.001) and septic shock (OR 12.81; p < 0.001) rates, length of stay (p < 0.001), and daily hospital costs (p = 0.01) were higher in the MDRGNB sepsis group than in the control group. CONCLUSIONS: Smaller preterm neonate with previous aminoglycoside use had a higher MDRGNB than non-MDRGNB sepsis compared with the control group. Intervention to reduce MDRGNB sepsis in the NICU is cost-effective. Copyright (c) 2019 Anucha Thatrimontrichai, Nutchana Premprat, Waricha Janjindamai, Supaporn Dissaneevate, Gunlawadee Maneenil.
INTRODUCTION: To identify the risks and outcomes for multidrug-resistant Gram-negative bacilli (MDRGNB) sepsis in neonates. METHODOLOGY: This was a retrospective case-case-control study between 1991 and 2016. The control group was selected from the same source records of all neonates with clinical or suspected sepsis but not culture-proven. RESULTS: The numbers of patients in the MDRGNB sepsis, non-MDRGNB sepsis, and control groups were 157, 88, and 218, respectively. MDRGNB sepsis was significantly associated with outborn infants [adjusted odds ratio (aOR) 2.08; p = 0.003] and infants who had a neurologic sequela (aOR 11.58; p = 0.04), lower gestational age (p = 0.03) or previous aminoglycoside use (aOR 2.43; p < 0.001) compared with the control group. Non-MDRGNB sepsis was associated with outborn infants (aOR 2.63; p < 0.001), and infants who had neurologic sequelae (aOR 48.25; p = 0.001) and previous cephalosporin use (aOR 6.28; p < 0.001) or cefoperazone plus sulbactam use (aOR 6.48; p = 0.02) compared with the control group. Case fatality (OR 3.63; p < 0.001) and septic shock (OR 12.81; p < 0.001) rates, length of stay (p < 0.001), and daily hospital costs (p = 0.01) were higher in the MDRGNB sepsis group than in the control group. CONCLUSIONS: Smaller preterm neonate with previous aminoglycoside use had a higher MDRGNB than non-MDRGNB sepsis compared with the control group. Intervention to reduce MDRGNB sepsis in the NICU is cost-effective. Copyright (c) 2019 Anucha Thatrimontrichai, Nutchana Premprat, Waricha Janjindamai, Supaporn Dissaneevate, Gunlawadee Maneenil.
Authors: Rebecca Milton; David Gillespie; Calie Dyer; Khadijeh Taiyari; Maria J Carvalho; Kathryn Thomson; Kirsty Sands; Edward A R Portal; Kerenza Hood; Ana Ferreira; Thomas Hender; Nigel Kirby; Jordan Mathias; Maria Nieto; William J Watkins; Delayehu Bekele; Mahlet Abayneh; Semaria Solomon; Sulagna Basu; Ranjan K Nandy; Bijan Saha; Kenneth Iregbu; Fatima Z Modibbo; Stella Uwaezuoke; Rabaab Zahra; Haider Shirazi; Syed U Najeeb; Jean-Baptiste Mazarati; Aniceth Rucogoza; Lucie Gaju; Shaheen Mehtar; Andre N H Bulabula; Andrew C Whitelaw; Timothy R Walsh; Grace J Chan Journal: Lancet Glob Health Date: 2022-05 Impact factor: 38.927