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Carbapenem-resistant Enterobacterales colonization and subsequent infection in a neonatal intensive care unit in Shanghai, China.
Yin, L; He, L; Miao, J; Yang, W; Wang, X; Ma, J; Wu, N; Cao, Y; Wang, C.
Afiliación
  • Yin L; Department of Nosocomial Infection Control, Children's Hospital of Fudan University, Shanghai, China.
  • He L; Clinical Microbiology Laboratory, Children's Hospital of Fudan University, Shanghai, China.
  • Miao J; Department of Nosocomial Infection Control, Children's Hospital of Fudan University, Shanghai, China.
  • Yang W; Department of Nosocomial Infection Control, Children's Hospital of Fudan University, Shanghai, China.
  • Wang X; Department of Nosocomial Infection Control, Children's Hospital of Fudan University, Shanghai, China.
  • Ma J; Department of Nosocomial Infection Control, Children's Hospital of Fudan University, Shanghai, China.
  • Wu N; Department of Nosocomial Infection Control, Children's Hospital of Fudan University, Shanghai, China.
  • Cao Y; Neonatal Intensive Care Unit, Children's Hospital of Fudan University, Shanghai, China.
  • Wang C; Department of Nosocomial Infection Control and the Clinical Microbiology Laboratory, Children's Hospital of Fudan University, Shanghai, China.
Infect Prev Pract ; 3(3): 100147, 2021 Sep.
Article en En | MEDLINE | ID: mdl-34647006
BACKGROUND: Colonization has been reported to play an important role in carbapenem-resistant Enterobacterales (CRE) infection; however, the extent to which carriers develop clinical CRE infection and related risk factors in neonatal intensive care unit (NICU) patients is unclear. AIM: To investigate the frequency of CRE colonization and its contribution to infections in NICU patients. METHODS: CRE colonization screening and CRE infection surveillance were performed in the NICU in 2017 and 2018. FINDINGS: Among 1230 unique NICU patients who were screened for CRE colonization, 144 patients tested positive (11.7%, 144/1230), with 9.2% (110/1197) in the intestinal tract, which was higher than that in the upper respiratory tract (6.6%, 62/945) (P=0.026). Gestational age, low birth weight and prolonged hospitalization were risk factors for CRE colonization (all P<0.001). Diversilab homology monitoring found an overall 17.4% (25/144) risk of infection among patients colonized with CRE. For carbapenem-resistant Klebsiella pneumoniae (CR-KP) and carbapenem-resistant Escherichia coli (CR-ECO), the risks were 19.1% (21/110) and 13.8% (4/29), respectively. The independent risk factors for CR-KP clinical infection among CR-KP carriers were receiving mechanical ventilation (odds ratio (OR), 10.177; 95% confidence interval (CI), 2.667-38.830; P=0.013), a high level of neonatal nutritional risk assessment (OR, 0.251; 95% CI, 0.072-0.881; P=0.031) and a high neonatal acute physiology II (SNAP-II) score (OR, 0.256; 95% CI, 0.882-1.034; P=0.025). CONCLUSIONS: The colonization of CRE may increase the incidence of corresponding CRE infection in NICU patients. Receiving mechanical ventilation, malnutrition and critical conditions with high SNAP-II scores were independent risk factors for subsequent CR-KP clinical infection.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Risk_factors_studies Idioma: En Revista: Infect Prev Pract Año: 2021 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Risk_factors_studies Idioma: En Revista: Infect Prev Pract Año: 2021 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido