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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
High frequency of multidrug-resistant gram-negative rods in 2 neonatal intensive care units in the Philippines
Infection Control and Hospital Epidemiology, Volume 30, No. 6, Year 2009
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Description
background. Although hospital-acquired infections appear to be a growing threat to the survival of newborns in the developing world, the epidemiology of this problem remains poorly characterized. methods. During a 10-month period, we conducted prospective longitudinal surveillance for colonization and bloodstream infection caused by gram-negative rods among all infants hospitalized in the 2 largest neonatal intensive care units in Manila, the Philippines. We determined antibiotic susceptibilities and calculated adjusted odds ratios for risk factors for bacteremia by means of multivariate logistic regression. results. Of 1,831 neonates enrolled during a 10-month period, 1,017 (55.5%) became newly colonized and 358 (19.6%) became bacteremic with a drug-resistant gram-negative rod, most commonly Klebsiella species, Enterobacter species, Acinetobacter species, and Pseudomonas aeruginosa. Of the invasive isolates, 20% were resistant to imipenem, 41% to trimethoprim-sulfamethoxazole, 52% to amikacin, 63% to ampicillin-sulbactam, 67% to ceftazidime, and 80% to tobramycin. The factors significantly associated with an increased risk of bacteremia were mechanical ventilation and prematurity. Additionally, colonization with a drug-resistant gram-negative rod was an independent risk factor for bacteremia (odds ratio, 1.4 [95% confidence interval, 1.0-1.9]). conclusions. Colonization with a drug-resistant gram-negative rod was an independent risk factor for sepsis. If our data are typical, the unusually high intensity of colonization pressure and disease caused by multidrug-resistant gram-negative rods at these 2 neonatal intensive care units indicates an emerging healthcare crisis in the developing world. Improved infection control methods are therefore critically needed in developing countries. © 2009 by The Society for Healthcare Epidemiology of America. All rights reserved.
Authors & Co-Authors
Gill, Christopher John
United States, Boston
School of Public Health
Fox, Matthew P.
United States, Boston
School of Public Health
MacLeod, William Bruce
United States, Boston
School of Public Health
Mendoza, Myrna T.
Netherlands, Zoetermeer
Nutricia Nederland
Hamer, Davidson Howes
United States, Boston
School of Public Health
Statistics
Citations: 38
Authors: 5
Affiliations: 7
Identifiers
Doi:
10.1086/597512
ISSN:
0899823X
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Cohort Study
Case-Control Study