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Infect Control Hosp Epidemiol. 2001 Dec;22(12):767-70.

Neonatal bacteremia: patterns of antibiotic resistance.

Author information

1
Department of Neonatology, Hadassah University Hospitals, Jerusalem, Israel.

Abstract

OBJECTIVE:

To determine the incidence and evaluate the antimicrobial-susceptibility patterns of bacterial infections in our neonatal units.

DESIGN:

Retrospective surveillance study.

SETTING:

The neonatal units of the Hadassah University Hospitals, Jerusalem, Israel.

PATIENTS:

All newborns admitted from January 1994 through February 1999.

METHODS:

The records of all patients with positive blood and cerebrospinal fluid cultures were reviewed. Bacteremia was considered early-onset (vertical) when occurring within the first 72 hours of life and late-onset (nosocomial) when occurring later. The prevalence and antibiotic-resistance patterns of vertically transmitted and nosocomially acquired strains were compared and studied over time.

RESULTS:

219 of 35,691 newborn infants had at least one episode of bacteremia (6.13/1,000 live births). There were 305 identified organisms, of which 21% (1.29/1,000 live births) were considered vertically transmitted and 79% nosocomially acquired. The most common organism causing early-onset disease (29.2%) was group B streptococcus (0.38/1,000 live births), whereas coagulase-negative staphylococci (51%) were the most prevalent in late-onset disease. All gram-positive bacteria were susceptible to vancomycin. Most gram-positive organisms other than staphylococci were susceptible to ampicillin. Gram-negative organisms represented 31% of all isolates. Generally, there was a trend of increasing resistance to commonly used antibiotics among nosocomially acquired gram-negative organisms, compared to those vertically transmitted, with statistically significant differences for ampicillin and mezlocillin (P<.05 and P<.01, respectively). Over the years, a trend toward an increasing resistance to antibiotics was observed among gram-negative organisms.

CONCLUSIONS:

The trend of increasing bacterial resistance to commonly used antibiotics necessitates the implementation of a rational empirical treatment strategy, based on local susceptibility data, reserving certain agents for emerging resistant pathogens.

PMID:
11876455
DOI:
10.1086/501860
[Indexed for MEDLINE]

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