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Gastrointestinal colonization with ESBL-producing Klebsiella in preterm babies—is vancomycin to blame?

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In this study, we examine the possible association between treatment with vancomycin and colonization with extended-spectrum beta-lactamase (ESBL)-producing Klebsiella in our neonatal intensive care unit (NICU). Variables compared between newborns which developed rectal colonization and those who did not include: gestational age, birth weight, gender, and total length of hospital stay until positive stool culture or discharge, treatment with vancomycin, and positive blood culture for coagulase-negative Staphylococcus. We found that lower birth weight, younger gestational age, and treatment with vancomycin were statistically significant risk factors for gastrointestinal colonization with ESBL-producing Klebsiella. When applying a multivariate model, treatment with vancomycin, both for a full 10-day course and for a short 3-day empirical treatment, remained statistically significant. Treatment with vancomycin is a risk factor for gastrointestinal colonization with ESBL-producing Klebsiella in premature babies.

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Correspondence to N. Ofek-Shlomai.

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R. Braunstein is an independent statistical consultant for biomedical research.

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Ofek-Shlomai, N., Benenson, S., Ergaz, Z. et al. Gastrointestinal colonization with ESBL-producing Klebsiella in preterm babies—is vancomycin to blame?. Eur J Clin Microbiol Infect Dis 31, 567–570 (2012).

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