Risk factors for imipenem-resistant Pseudomonas aeruginosa in neonatal intensive care units in south China

Abstract

This multi-centre retrospective study was designed to investigate the risk factors for infection with imipenem-resistant Pseudomonas aeruginosa in neonatal intensive care units (NICUs) in south China. All patients with confirmed P. aeruginosa infection from eight NICUs in south China were divided into two groups: imipenem-susceptible P. aeruginosa and imipenem-resistant P. aeruginosa. Data were analysed using Chi-squared test and logistic regression. In total, 188 medical records were reviewed. On multi-variate logistic analysis, the only independent risk factor was imipenem treatment within two weeks of isolation of P. aeruginosa (odds ratio 6.409, 95% confidence interval 1.926-21.333).

Prior antibiotic use and acquisition of multidrug-resistant organisms in hospitalized children: A systematic review

“…The articles included in this review were all observational studies: 12 were cohort studies (7 retrospective studies [19][20][21][22][23][24] and 5 prospective studies [25][26][27][28][29] ) and 17 were case-control studies. [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] The study sample for all articles were hospitalized children, although their ages differed among the studies.…”

“…[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] The study sample for all articles were hospitalized children, although their ages differed among the studies. Seven studies included specific age ranges, 20,23,25,27,30,41,42 10 studies included only neonates, 19,21,24,26,28,29,32,37,38,47 and 12 studies did not provide an age range for the children included. 22,31,[33][34][35][36]39,40,[43][44][45][46] Organisms included in the articles were Enterobacteriaceae (n = 10), 19,22,26,…”

“…Seven studies included specific age ranges, 20,23,25,27,30,41,42 10 studies included only neonates, 19,21,24,26,28,29,32,37,38,47 and 12 studies did not provide an age range for the children included. 22,31,[33][34][35][36]39,40,[43][44][45][46] Organisms included in the articles were Enterobacteriaceae (n = 10), 19,22,26,35,36,[41][42][43][44][45] Klebsiella pneumoniae (n = 8), 21,23,27,28,34,38,46,47 Escherichia coli (n = 5), 23,33,37,46...…”

“…22,31,[33][34][35][36]39,40,[43][44][45][46] Organisms included in the articles were Enterobacteriaceae (n = 10), 19,22,26,35,36,[41][42][43][44][45] Klebsiella pneumoniae (n = 8), 21,23,27,28,34,38,46,47 Escherichia coli (n = 5), 23,33,37,46,47 gramnegative bacteria (n = 3), 20,30,39 Acinetobacter baumannii (n = 3), 29,32,40 Enterococcus faecalis or E. faecium (n = 1), 31 Pseudomonas aeruginosa (n = 1), 24 Serratia marcescens (n = 1), 28 and Streptococcus pneumoniae (n = 1). 25 For HAIs, 8 studies included all types of infections, 19,21,24,25,…”

“…[19][20][21][30][31][32] Furthermore, 5 studies examined HACs only, 26,34,39,43,45 and 8 studies did not distinguish between HAIs and HACs. 28,33,[35][36][37][38]40,44 Ascertainment of antibiotic exposure differed across studies: 86% (n = 25) abstracted antibiotic use from the medical record, 19,20,[22][23][24][26][27][28][29][31][32][33][34][35][37][38][39][40][41][42][43][44][45][46][47] 3% (n = 1) utilized both parental recall and the medical record, 25 and 10% (n = 3) did not explicitly state how antibiotic exposure was ascertained. 21,30,36 Each study varied in its definitions of antibiotic use and HAI and/or HAC with an MDRO.…”