Risk factors and outcomes of carbapenem-resistant Acinetobacter baumannii ventilator-associated pneumonia in the neonate: A case-case-control study

Thatrimontrichai, Anucha; Techato, Chirabat; Dissaneevate, Supaporn; Janjindamai, Waricha; Maneenil, Gunlawadee; Kritsaneepaiboon, Supika; Tanaanantarak, Pattama

doi:10.1016/j.jiac.2016.03.013

Cited by 29 publications

(59 citation statements)

References 24 publications

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“…Regarding antibiotic stewardship programs, one study found such programs significantly reduced the incidence of infections and colonizations by MDRGNB (51% reduction; incidence ratio, 0.49; 95% CI: 0.35-0.68) [18]. Our study is further confirmation that the rate of MDRGNB sepsis is increasing in developing countries [3,12,17], and physicians and other health personnel should become ever more vigilant concerning prevention and infection control.…”

Section: Discussionsupporting

confidence: 74%

“…Several studies have found that patients with an MDRGNB infection had poorer outcomes than non-MDRGNB and control groups [3,16,17]. Regarding antibiotic stewardship programs, one study found such programs significantly reduced the incidence of infections and colonizations by MDRGNB (51% reduction; incidence ratio, 0.49; 95% CI: 0.35-0.68) [18].…”

Section: Discussionmentioning

confidence: 99%

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Multidrug-resistant Gram-negative bacilli sepsis from a neonatal intensive care unit: a case-case-control study

Thatrimontrichai

Premprat

Janjindamai

et al. 2019

J Infect Dev Ctries

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Introduction: To identify the risks and outcomes for multidrug-resistant Gram-negative bacilli (MDRGNB) sepsis in neonates. Methodology: This was a retrospective case-case-control study between 1991 and 2016. The control group was selected from the same source records of all neonates with clinical or suspected sepsis but not culture-proven. Results: The numbers of patients in the MDRGNB sepsis, non-MDRGNB sepsis, and control groups were 157, 88, and 218, respectively. MDRGNB sepsis was significantly associated with outborn infants [adjusted odds ratio (aOR) 2.08; p = 0.003] and infants who had a neurologic sequela (aOR 11.58; p = 0.04), lower gestational age (p = 0.03) or previous aminoglycoside use (aOR 2.43; p < 0.001) compared with the control group. Non-MDRGNB sepsis was associated with outborn infants (aOR 2.63; p < 0.001), and infants who had neurologic sequelae (aOR 48.25; p = 0.001) and previous cephalosporin use (aOR 6.28; p < 0.001) or cefoperazone plus sulbactam use (aOR 6.48; p = 0.02) compared with the control group. Case fatality (OR 3.63; p < 0.001) and septic shock (OR 12.81; p < 0.001) rates, length of stay (p < 0.001), and daily hospital costs (p = 0.01) were higher in the MDRGNB sepsis group than in the control group. Conclusions: Smaller preterm neonate with previous aminoglycoside use had a higher MDRGNB than non-MDRGNB sepsis compared with the control group. Intervention to reduce MDRGNB sepsis in the NICU is cost-effective.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Multidrug-resistant Gram-negative bacilli sepsis from a neonatal intensive care unit: a case-case-control study

Thatrimontrichai

Premprat

Janjindamai

et al. 2019

J Infect Dev Ctries

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“…4 However, antimicrobial-resistant pathogens may colonize from antibiotic selective pressure due to frequent and prolonged broad-spectrum antimicrobial use. 5 The emergence of MDR-GNB sepsis is particularly worrisome due to the consideration of off-label use of meropenem and colistin in neonates. [5][6][7] Very little information is available on the risk factors to identify 30-day mortality in patients with GNB sepsis in the NICU as well as MDR-GNB sepsis.…”

mentioning

confidence: 99%

“…5 The emergence of MDR-GNB sepsis is particularly worrisome due to the consideration of off-label use of meropenem and colistin in neonates. [5][6][7] Very little information is available on the risk factors to identify 30-day mortality in patients with GNB sepsis in the NICU as well as MDR-GNB sepsis. Therefore, we aimed to clarify the risk factors for the 30-day mortality rate in neonates with GNB sepsis in Thailand.…”

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confidence: 99%

Risk Factors for 30-Day Mortality in Neonatal Gram-Negative Bacilli Sepsis

et al. 2019

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Objective Multidrug-resistant gram-negative bacilli (MDR-GNB) have emerged globally as a serious threat and with a high case fatality rate (CFR). Study Design We performed a case–control study in a Thai neonatal intensive care unit to identify the risk factors for 30-day CFR of GNB sepsis between 1991 and 2017. The CFR was analyzed by Cox's proportional hazards model. Results For 27 years, the percentage of MDR-GNB from GNB sepsis was 66% (169/257). The medians (interquartile ranges) of gestational age and birth weight of the neonates with GNB sepsis were 33 (29–38) weeks and 1,817 (1,100–2,800) grams, respectively. The 30-day CFRs of the neonates with MDR-GNB and non-MDR-GNB sepsis were 33% (56/169) and 20% (18/88), respectively, (hazard ratio [HR] = 1.74; 95% confidence interval [CI]: 1.03–2.97; p = 0.04). Using Cox's proportional hazards model, nonsurvivors in GNB sepsis were more likely to have septic shock (adjusted HR [aHR] = 6.67; 95% CI: 3.28–13.57; p < 0.001) or no microbiological cure (aHR = 10.65; 95% CI: 4.98–22.76; p < 0.001) than survivors. Conclusion Neonates suspected of sepsis with septic shock need broad-spectrum empirical antimicrobial therapy until the second successive negative culture, especially in high MDR areas.

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“…The 10th and 50th percentiles of onset of MDR Gram negative bacilli (MDRGNB) sepsis were 2.2 and 8.9 days after birth, respectively. Accordingly, we suggest a cut-off point of 48 hours (10th percentile onset of MDRGNB sepsis) between EOS and LOS to be the appropriate time to start or step up to broad-spectrum antimicrobial therapy, especially in cases of septic shock or in a moribund neonate in a high MDR area (Thatrimontrichai et al 2016, Thatrimontrichai et al 2013.…”

Section: Definition and Cut-off Point Of Neonatal Infectionmentioning

confidence: 99%

Review article: Neonatal Sepsis in Thailand

Thatrimontrichai

2018

FMI

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Neonatal sepsis is a burden around the world and causes high mortality and morbidity as well. Long-term neurodevelopmental disability may occur in survivors. General physicians, pediatricians, and neonatologists need be attentive to the proper diagnosis, starting, de-escalating or stopping empirical antimicrobials therapy in neonatal sepsis. Furthermore, multidrug resistant organisms have emerged among adults, children, and neonates in developing countries. Local epidemiology studies and antimicrobial stewardship programs are important for application of the best and specific treatments. Knowledge, definitions, and clinical practice of neonatal sepsis are updated in this review. ABSTRAKSepsis neonatal adalah salah satu permasalahan yang berat di seluruh dunia dan menyebabkan mortalitas dan morbiditas yang tinggi. Cacat perkembangan saraf jangka panjang dapat terjadi pada pasien yang dapat bertahan. Dokter umum, dokter anak, dan ahli neonatologi perlu memperhatikan diagnosis yang tepat, memulai, mengurangi atau menghentikan terapi antimikroba empiris pada sepsis neonatal. Lebih lanjut, organisme resisten multidrug telah muncul di antara orang dewasa, anak-anak, dan neonatus di negara berkembang. Studi epidemiologi lokal dan program penatagunaan antimikroba penting untuk penerapan perawatan terbaik dan spesifik. Pengetahuan, definisi, dan praktik klinis sepsis neonatal diperbarui dalam ulasan ini. Kata kunci: infeksi silang; sepsis neonatorum; bayi baru lahir; transmisi penyakit menular vertikal

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Risk factors and outcomes of carbapenem-resistant Acinetobacter baumannii ventilator-associated pneumonia in the neonate: A case-case-control study

Cited by 29 publications

References 24 publications

Multidrug-resistant Gram-negative bacilli sepsis from a neonatal intensive care unit: a case-case-control study

Multidrug-resistant Gram-negative bacilli sepsis from a neonatal intensive care unit: a case-case-control study

Risk Factors for 30-Day Mortality in Neonatal Gram-Negative Bacilli Sepsis

Review article: Neonatal Sepsis in Thailand

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