Prevalence study of antimicrobial resistant organisms in very preterm neonates.

IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Irish Journal of Medical Science Pub Date : 2025-02-26 DOI:10.1007/s11845-025-03903-w
Elaine Houlihan, Anna McCormick, Carol O ' Connor, Susan J Knowles
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Abstract

Background: Preterm neonates have underdeveloped organs, a fragile skin barrier and an immature immune system rendering them susceptible to infection. These infants are at an increased risk of developing a healthcare-associated infection because of antibiotic exposure, invasive monitoring and the general risk of outbreaks within a hospital setting. The aim of this study was to investigate the prevalence of antimicrobial resistant organism carriage in very preterm neonates (i.e. born ≤ 32 weeks gestation) in the neonatal intensive care unit (NICU).

Methods: Neonates born ≤ 32 weeks' gestation in NMH from September 2022 to January 2023 were included. Swabs were taken at admission and fortnightly until week 10 of life. Screening investigations included ESBL (Extended Spectrum Beta-Lactamases) and AmpC producers, organisms resistant to gentamicin and ciprofloxacin, CPE (Carbapenemase-producing Enterobacterales), MRSA (Methicillin-resistant Staphylococcus aureus) and VRE (Vancomycin-resistant Enterococci). This differed from baseline screening by frequency of screening, and the recording of presence of AmpC-producers and ciprofloxacin-resistance. Ethical approval was sought and granted.

Results: Overall, 20 out of the 53 neonates (38%) included in the study were colonised with one or more resistant-gram-negative organism; 5 with ESBL (9%), 2 resistant to gentamicin (4%), 6 resistant to ciprofloxacin (11%) and 14 (26%) with AmpC producers. Three (6%) resistant gram-negative bacilli were detected on admission screens, and resistance rates peaked at week 4 where 14 screens were positive. No CPE, MRSA or VRE were isolated.

Discussion/conclusion: This study highlights the prevalence of antibiotic-resistant organisms in a vulnerable patient cohort, the very preterm infants. This review should prompt revision of the importance of infection prevention and control, antimicrobial stewardship and regular MDRO (multi-drug resistant organism) screening in the neonatal critical care setting.

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来源期刊
Irish Journal of Medical Science
Irish Journal of Medical Science 医学-医学:内科
CiteScore
3.70
自引率
4.80%
发文量
357
审稿时长
4-8 weeks
期刊介绍: The Irish Journal of Medical Science is the official organ of the Royal Academy of Medicine in Ireland. Established in 1832, this quarterly journal is a contribution to medical science and an ideal forum for the younger medical/scientific professional to enter world literature and an ideal launching platform now, as in the past, for many a young research worker. The primary role of both the Academy and IJMS is that of providing a forum for the exchange of scientific information and to promote academic discussion, so essential to scientific progress.
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