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Background <p>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.</p> <p>The aim of this study was to investigate the prevalence of antimicrobial resistant organism carriage in very preterm neonates (i.e. born ≤ 32&#xa0;weeks gestation) in the neonatal intensive care unit (NICU).</p> Methods <p>Neonates born ≤ 32&#xa0;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 <i>Enterobacterales</i>), MRSA (Methicillin-resistant <i>Staphylococcus aureus</i>) and VRE (Vancomycin-resistant <i>Enterococci</i>). 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.</p> Results <p>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.</p> Discussion/Conclusion <p>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&#xa0;importance of infection prevention and control, antimicrobial stewardship and regular MDRO (multi-drug resistant organism)&#xa0;screening&#xa0;in the neonatal critical care setting.</p>

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Prevalence study of antimicrobial resistant organisms in very preterm neonates

  • 期刊论文

  • 发表日期：

    2025年2月26日

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  • Elaine Houlihan,
  • Anna McCormick,
  • Carol O.’ Connor,
  • Susan J. Knowles

摘要

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.