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Infection

, 35:339 | Cite as

Risk Factors of Nosocomial Infection with Extended-Spectrum Beta-Lactamase-Producing Bacteria in a Neonatal Intensive Care Unit in China

  • Y. Huang
  • S. Zhuang
  • M. Du
Clinical and Epidemiological Study

Abstract

Background:

To study risk factors of neonatal nosocomial infection caused by extended-spectrum beta-lactamase (ESBL)-producing bacteria in a neonatal intensive care unit (NICU).

Patients and Methods:

A retrospective cohort study was conducted in a university hospital NICU in south China. Medical records of neonatal nosocomial infection caused by Escherichia coli or Klebsiella pneumoniae were reviewed. Twenty-two neonates infected with ESBL-producing bacteria (case patients) were compared with 17 patients infected with non-ESBL producing strains (controls). Univariable and multivariable logistic regression were performed to analyze risk factors for infection with ESBL-producing strains. The spectrum of antimicrobial resistance of ESBL-positive E. coli or K. pneumoniae was also examined.

Results:

Both univariable and multivariable logistic regression analysis revealed that preterm low birth weight, prolonged mechanical ventilation (≥ 7 days) and prior use of third-generation cephalosporins were risks factors for ESBL-producing E. coli or K. pneumoniae infection (p < 0.05), with an odd ratio of 6.43 (95% CI: 1.51–27.44; p = 0.017), 7.50 (95% CI: 1.38–40.88; p = 0.017) and 9.00 (95% CI: 1.65–49.14; p = 0.008) respectively. However, the length of hospital stay before isolation of pathogens, endotracheal intubation, presence of a central venous catheter, days on third-generation cephalosporins and prior use of beta-lactamase inhibitors were not statistically significant (p > 0.05). Resistance of ESBL-positive strains to piperacillin, tobramycin, aztreonam and cephalosporins was significantly higher than that of ESBL-negative ones (p < 0.05). ESBL-producing strains appeared susceptible to carbapenem, fluoroquinolones, and beta-lactamase inhibitor combination piperacillin-tazobactam.

Conclusions:

Preterm low birth weight, prolonged mechanical ventilation and prior use of third-generation cephalosporins are risks factors for nosocomial infection with ESBL-producing bacteria in NICU.

Keywords

Nosocomial Infection Neonatal Intensive Care Unit Klebsiella Pneumoniae Prolonged Mechanical Ventilation Infect Control Hosp 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Copyright information

© Urban & Vogel München 2007

Authors and Affiliations

  1. 1.Dept. of Pediatrics, First Affiliated HospitalSun Yat-sen UniversityGuangzhouPeople's Republic of China

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