Evaluating the Use of Neonatal Colonization Screening for Empiric Antibiotic Therapy of Sepsis and Pneumonia

Background Since 2013, weekly screening for multidrug-resistant gramnegative (MDRGN) bacteria is performed in German neonatal intensive care units (NICU). National guidelines recommend considering these colonization analyses for antibiotic treatment regimens. Our retrospective single center study provides insight into the clinical dichotomy of bacterial colonization and infection rates in neonates.

Methods We analyzed microbiological data of neonates admitted to our tertiary level NICU over nine years. Colonization with MDRGN/Serratia marcescens (SERMA) was compared to microbiological findings in sepsis and pneumonia.

Results We analyzed 917 blood and 1,799 tracheal aspirate samples. After applying criteria from the Nosocomial Infection Surveillance for Neonates (Neo-Kiss), we included 52 and 55 cases of sepsis and pneumonia, respectively. 19.2% of sepsis patients and 34.5% of pneumonia patients had a prior colonization with MDRGN bacteria or SERMA. In these patients, sepsis was not attributable to MDRGN bacteria yet one SERMA, while in pneumonias ten MDRGN bacteria and one SERMA were identified. We identified late-onset pneumonia and caesarean section as risk factors for MDRGN/SERMA acquisition [1].

Conclusions Colonization screening is a useful tool for hygiene surveillance. However, our data suggest that consideration of colonization with MDRGN/SERMA might promote extensive use of last resort antibiotics in neonates.

 

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Morhart P. besuchte gesponserte Fortbildungen von Chiesi und Alveofact

• Literatur

• 1 Bär A., Schmitt-Grohé S., Held J., Lubig J., Hanslik G., Fahlbusch F.B., Reutter H., Woelfle J., van der Donk A., Schleier M.. et al. Evaluating the Use of Neonatal Colonization Screening for Empiric Antibiotic Therapy of Sepsis and Pneumonia. Antibiotics 2023; 12: 189 10.3390/antibiotics12020189

Publication History

Article published online:
06 June 2023