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Banar M, Sattari-Maraji A, Bayatinejad G, Ebrahimi E, Jabalameli L, Beigverdi R, Emaneini M, Jabalameli F. Global prevalence and antibiotic resistance in clinical isolates of Stenotrophomonas maltophilia: a systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1163439. [PMID: 37215718 PMCID: PMC10196134 DOI: 10.3389/fmed.2023.1163439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/14/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Stenotrophomonas maltophilia is a little-known environmental opportunistic bacterium that can cause broad-spectrum infections. Despite the importance of this bacterium as an emerging drug-resistant opportunistic pathogen, a comprehensive analysis of its prevalence and resistance to antibiotics has not yet been conducted. Methods A systematic search was performed using four electronic databases (MEDLINE via PubMed, Embase, Scopus, and Web of Science) up to October 2019. Out of 6,770 records, 179 were documented in the current meta-analysis according to our inclusion and exclusion criteria, and 95 studies were enrolled in the meta-analysis. Results Present analysis revealed that the global pooled prevalence of S. maltophilia was 5.3 % [95% CI, 4.1-6.7%], with a higher prevalence in the Western Pacific Region [10.5%; 95% CI, 5.7-18.6%] and a lower prevalence in the American regions [4.3%; 95% CI, 3.2-5.7%]. Based on our meta-analysis, the highest antibiotic resistance rate was against cefuroxime [99.1%; 95% CI, 97.3-99.7%], while the lowest resistance was correlated with minocycline [4·8%; 95% CI, 2.6-8.8%]. Discussion The results of this study indicated that the prevalence of S. maltophilia infections has been increasing over time. A comparison of the antibiotic resistance of S. maltophilia before and after 2010 suggested there was an increasing trend in the resistance to some antibiotics, such as tigecycline and ticarcillin-clavulanic acid. However, trimethoprim-sulfamethoxazole is still considered an effective antibiotic for treating S. maltophilia infections.
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Affiliation(s)
- Maryam Banar
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Sattari-Maraji
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghazal Bayatinejad
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Ebrahimi
- Department of Microbiology, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Leila Jabalameli
- Department of Microbiology, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Reza Beigverdi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Emaneini
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Jabalameli
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Antibiotic Stewardship and Antimicrobial Resistance, Tehran University of Medical Sciences, Tehran, Iran
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Cuna A, Morowitz MJ, Sampath V. Early antibiotics and risk for necrotizing enterocolitis in premature infants: A narrative review. Front Pediatr 2023; 11:1112812. [PMID: 36865691 PMCID: PMC9971631 DOI: 10.3389/fped.2023.1112812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/24/2023] [Indexed: 02/16/2023] Open
Abstract
While prompt initiation of antibiotics at birth due to concerns for early onset sepsis is common, it often leads to many preterm infants being exposed to treatment despite negative blood cultures. Such exposure to early antibiotics can impact the developing gut microbiome putting infants at increased risk of several diseases. Necrotizing enterocolitis (NEC), a devastating inflammatory bowel disease that affects preterm infants, is among the most widely studied neonatal disease that has been linked to early antibiotics. While some studies have demonstrated an increased risk of NEC, other studies have demonstrated seemingly contrary findings of decreased NEC with early antibiotics. Studies using animal models have also yielded differing findings of benefit vs. harm of early antibiotic exposure on subsequent NEC susceptibility. We thus sought to conduct this narrative review to help clarify the relationship between early antibiotics exposure and future risk of NEC in preterm infants. Our objectives are to: (1) summarize findings from human and animal studies that investigated the relationship between early antibiotics and NEC, (2) highlight important limitations of these studies, (3) explore potential mechanisms that can explain why early antibiotics may increase or decrease NEC risk, and (4) identify future directions for research.
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Affiliation(s)
- Alain Cuna
- Division of Neonatology, Children's Mercy Kansas City, Kansas City, MOUnited States
- School of Medicine, University of Missouri-Kansas City, Kansas City, MOUnited States
| | - Michael J. Morowitz
- Division of Pediatric General and Thoracic Surgery, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PAUnited States
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Venkatesh Sampath
- Division of Neonatology, Children's Mercy Kansas City, Kansas City, MOUnited States
- School of Medicine, University of Missouri-Kansas City, Kansas City, MOUnited States
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Yu YQ, He XR, Wan LJ, Yang YH, Chen PY. Etiology, antimicrobial resistance, and risk factors of neonatal sepsis in China: a systematic review and meta-analysis from data of 30 years. J Matern Fetal Neonatal Med 2021; 35:7541-7550. [PMID: 34470123 DOI: 10.1080/14767058.2021.1951217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the regional etiology, antimicrobial resistance (AMR) pattern, and risk factors in neonates with sepsis in China. METHODS We performed a systematic review and meta-analysis by searching Medline, Embase, Scopus, and Web of Science in December 2020. Studies of neonatal sepsis from China published between 2011 and 2020 were included. We pooled the proportion of pathogens and calculated the odds ratios of risk factors with 95% CIs using a random-effects model. RESULTS We included 29 studies of 164,750 neonates with sepsis. The studies comprise data from 1990 to 2019. Coagulase-negative staphylococci (CoNS), Escherichia coli and Klebsiella spp accounted for 33% (95% CI 24-43), 17% (13-20), and 14% (11-17), respectively. Group B streptococcus (GBS) was the predominant isolate in early-onset sepsis (EOS) (21%, 95% CI 10-31), while the proportion of CoNS was the largest in late-onset sepsis (LOS) (32%, 95% CI 22-43). Resistance of CoNS to penicillin was found in 95% (95% CI 92-98) of 511 cases and Klebsiella spp to ampicillin in 95% (95% CI 90-99) of 364 cases. Maternal underlying diseases (2.61, 95% CI 1.48-4.61), mechanical ventilation (2.41, 1.37-4.23), central venous catheter placement (2.74, 1.77-4.26), peripherally inserted central catheter (PICC) placement (4.26, 2.80-6.49), multiple antibiotic uses (5.35, 1.85-15.43) and total parenteral nutrition (7.96, 2.04-31.02) were risk factors of neonatal sepsis. CONCLUSION CoNS, E. coli, and Klebsiella spp were the predominant pathogens in neonatal sepsis in China. AMR was still a significant issue in NICUs. Total parenteral nutrition, multiple antibiotic uses, and PICC placement were the most relevant risk factors.
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Affiliation(s)
- Yuan-Qiang Yu
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,Laboratory of Neonatal Disease, Institute of Pediatrics, Central South University, Changsha, Hunan, China
| | - Xiao-Ri He
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,Laboratory of Neonatal Disease, Institute of Pediatrics, Central South University, Changsha, Hunan, China
| | - Li-Jia Wan
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,Laboratory of Neonatal Disease, Institute of Pediatrics, Central South University, Changsha, Hunan, China
| | - Yong-Hui Yang
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,Laboratory of Neonatal Disease, Institute of Pediatrics, Central South University, Changsha, Hunan, China
| | - Ping-Yang Chen
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,Laboratory of Neonatal Disease, Institute of Pediatrics, Central South University, Changsha, Hunan, China
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Gao XY, Dai YH, Fan DZ, Xie XY, Yang GD, Xiao X, Gao PM. The association between the microbes in the tracheobronchial aspirate fluid and bronchopulmonary dysplasia in preterm infants. Pediatr Neonatol 2020; 61:306-310. [PMID: 32144075 DOI: 10.1016/j.pedneo.2019.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/30/2019] [Accepted: 12/26/2019] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The study aimed to evaluate the association between microbes in the lower respiratory tract (LRT) and the srisk for severe bronchopulmonary dysplasia (sBPD) in premature infants. METHODS We conducted a retrospective, single-center study of preterm infants who were admitted to the neonatal intensive care unit (NICU) of Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, China, between January 2015 and December 2017. The microbes in the LRT were screened by using tracheobronchial aspirate fluid (TAF) culture. RESULTS One hundred and fifty-five infants were included in the analysis. Among 155 infants, 41 were diagnosed with sBPD, and 114 were diagnosed without sBPD. There were significant differences between infants with and without sBPD in regard to birth weight (BW), gestational age (GA), the duration of endotracheal ventilation and supplemental oxygen. The incidence of retinopathy (ROP) and sepsis was higher in the sBPD infants than in the infants without sBPD. There was a difference in the detection rate of Gram-negative bacteria (GNB) between the two groups. Stenotrophomonas maltophilia and Klebsiella pneumoniae were mainly detected in TAF. CONCLUSIONS The LRT microbes were different between infants with and without sBPD, and GNB is more frequently detected in sBPD infants.
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Affiliation(s)
- Xiao-Yan Gao
- Department of Neonatology, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, No. 11 Renmin West Road, Chancheng District, Foshan, 528000, China
| | - Yi-Heng Dai
- Department of Neonatology, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, No. 11 Renmin West Road, Chancheng District, Foshan, 528000, China
| | - Da-Zhi Fan
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, No. 11 Renmin West Road, Chancheng District, Foshan, 528000, China
| | - Xiao-Yun Xie
- Department of Neonatology, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, No. 11 Renmin West Road, Chancheng District, Foshan, 528000, China
| | - Guang-di Yang
- Department of Neonatology, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, No. 11 Renmin West Road, Chancheng District, Foshan, 528000, China
| | - Xin Xiao
- Department of Neonatology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510120, China.
| | - Ping-Ming Gao
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, No. 11 Renmin West Road, Chancheng District, Foshan, 528000, China.
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Gao K, Fu J, Guan X, Zhu S, Zeng L, Xu X, Chang CY, Liu H. Incidence, Bacterial Profiles, And Antimicrobial Resistance Of Culture-Proven Neonatal Sepsis In South China. Infect Drug Resist 2019; 12:3797-3805. [PMID: 31819560 PMCID: PMC6899077 DOI: 10.2147/idr.s223597] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/31/2019] [Indexed: 12/17/2022] Open
Abstract
Background Neonatal sepsis (NS) is one of the leading causes of infant morbidity and mortality, but little is known about pathogen incidence and distribution in China. Methods In this retrospective study (January 2012 to December 2016), culture-proven cases aged less than 28 days with diagnosed NS in the Guangzhou Women and Children’s Medical Center, South China, were analyzed for pathogen incidence and antimicrobial resistance. Results A total of 620 isolates were identified from 597 NS cases. Gram-negative bacteria (n=371, 59.8%) dominated over Gram-positive bacteria (n=218, 35.2%) and fungi (n=30, 4.8%). Klebsiella pneumoniae (21.9%), Escherichia coli (21.9%), group B Streptococcus (GBS, 13.2%), and Staphylococcus aureus (6.8%) were the four most predominant pathogens. In early-onset sepsis (EOS), GBS (30.0%) and E. coli (20.0%) were dominant, whereas in late-onset sepsis (LOS), K. pneumoniae (25.6%) and E. coli (22.4%) were dominant. E. coli (25.2%) and GBS (17.7%) were the most frequently isolated from term patients, whereas K. pneumoniae was the most frequently isolated from preterm patients (34.9%). Of the infected infants, 9.5% died from sepsis, most commonly by E. coli infection (16.2%). Among 91,215 live births (LBs) delivered in the study hospital (2012–2016), 252 infants developed sepsis infection (2.76 per 1000 LBs, 95% CI 2.4–3.1), including EOS (0.78 per 1000 LBs) and LOS (2.13 per 1000 LBs). All GBS isolates were susceptible to β-lactam antibiotics, and S. aureus, including methicillin-resistant isolates, were susceptible to vancomycin. An extended-spectrum β-lactamase producer was identified in 37.3% of E. coli and 50.4% of K. pneumoniae. Conclusion K. pneumoniae was the most frequent pathogen in culture-proven NS in South China, primarily associated with LOS in preterm, whereas GBS was the dominant pathogen in EOS. E. coli was common in both episodes with the highest mortality.
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Affiliation(s)
- Kankan Gao
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510623, People's Republic of China
| | - Jie Fu
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510623, People's Republic of China.,Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510623, People's Republic of China
| | - Xiaoshan Guan
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510623, People's Republic of China
| | - Sufei Zhu
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510623, People's Republic of China
| | - Lanlan Zeng
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510623, People's Republic of China
| | - Xiaoming Xu
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510623, People's Republic of China
| | - Chien-Yi Chang
- School of Chemistry and Biosciences, University of Bradford, Bradford BD7 1DP, UK
| | - Haiying Liu
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510623, People's Republic of China
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Cao Y, Jiang S, Zhou Q. Introducing evidence-based practice improvement in Chinese neonatal intensive care units. Transl Pediatr 2019; 8:257-261. [PMID: 31413959 PMCID: PMC6675685 DOI: 10.21037/tp.2019.07.07] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
China has the largest population in the world. With rapid economic growth, the incidence of premature birth has shown an increasing trend and more neonatal intensive care units (NICUs) are being established across the country. However, there is substantial variability in clinical practice and variations in short- and long-term outcomes among patients in different NICUs. There remains a big gap between China and developed countries in terms of infant outcomes. The Evidence-based Practice for Improving Quality (EPIQ) is a successful model that has been implemented in NICUs across Canada to improve infant outcomes. We applied EPIQ in a single NICU in china and successfully reduced the incidence of ventilator-associated pneumonia, central line (CL) associated bloodstream infection (CLABSIs), and improved the breastmilk use in NICU. In the next phase, we are extending EPIQ to another 24 centers in China and have established the Chinese Neonatal Network for national collaboration, to improve infant outcomes across China.
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Affiliation(s)
- Yun Cao
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Siyuan Jiang
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Qi Zhou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China
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Peters L, Olson L, Khu DTK, Linnros S, Le NK, Hanberger H, Hoang NTB, Tran DM, Larsson M. Multiple antibiotic resistance as a risk factor for mortality and prolonged hospital stay: A cohort study among neonatal intensive care patients with hospital-acquired infections caused by gram-negative bacteria in Vietnam. PLoS One 2019; 14:e0215666. [PMID: 31067232 PMCID: PMC6505890 DOI: 10.1371/journal.pone.0215666] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 04/05/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Antibiotic resistance (ABR) is an increasing burden for global health. The prevalence of ABR in Southeast Asia is among the highest worldwide, especially in relation to hospital-acquired infections (HAI) in intensive care units (ICU). However, little is known about morbidity and mortality attributable to ABR in neonates. AIM This study aimed to assess mortality and the length of hospitalization attributable to ABR in gram-negative bacteria (GNB) causing HAI in a Vietnamese neonatal ICU (NICU). METHODS We conducted a prospective cohort study (n = 296) in a NICU in Hanoi, Vietnam, from March 2016 to October 2017. Patients isolated with HAI caused by GNB were included. The exposure was resistance to multiple antibiotic classes, the two outcomes were mortality and length of hospital stay (LOS). Data were analysed using two regression models, controlling for confounders and effect modifiers such as co-morbidities, time at risk, severity of illness, sex, age, and birthweight. RESULTS The overall case fatality rate was 44.3% and the 30 days mortality rate after infection was 31.8%. For every additional resistance to an antibiotic class, the odds of a fatal outcome increased by 27% and LOS increased by 2.1 days. These results were statistically significant (p < 0.05). CONCLUSION ABR was identified as a significant risk factor for adverse outcomes in neonates with HAI. These findings are generally in line with previous research in children and adults. However, heterogeneous study designs, the neglect of important confounders and varying definitions of ABR impair the validity, reliability, and comparability of results.
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Affiliation(s)
- Lynn Peters
- Global Health program, Karolinska Institutet, Stockholm, Sweden
| | - Linus Olson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Training and Research Academic Collaboration Sweden-Vietnam, Karolinska Institutet, Stockholm, Sweden
| | - Dung T. K. Khu
- Training and Research Academic Collaboration Sweden-Vietnam, Karolinska Institutet, Stockholm, Sweden
- Department of Neonatology, Vietnam National Children’s Hospital, Hanoi, Vietnam
| | - Sofia Linnros
- Global Health program, Karolinska Institutet, Stockholm, Sweden
| | - Ngai K. Le
- Training and Research Academic Collaboration Sweden-Vietnam, Karolinska Institutet, Stockholm, Sweden
- Department of Microbiology, Vietnam National Children’s Hospital, Hanoi, Vietnam
| | - Håkan Hanberger
- Department of Clinical and Experimental Medicine, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Ngoc T. B. Hoang
- Department of Microbiology, Vietnam National Children’s Hospital, Hanoi, Vietnam
| | - Dien M. Tran
- Research Institute for Child Health, Hanoi, Vietnam
- Department of Surgery, Vietnam National Children’s Hospital, Hanoi, Vietnam
| | - Mattias Larsson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Training and Research Academic Collaboration Sweden-Vietnam, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
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Breaking down barriers: enabling care-by-parent in neonatal intensive care units in China. World J Pediatr 2017; 13:144-151. [PMID: 27917447 DOI: 10.1007/s12519-016-0072-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Accepted: 07/09/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Denying parents access to their infant in the Neonatal Intensive Care Unit (NICU) is a standard practice in most hospitals across China. Visitation is not usually permitted or may be strictly limited, and NICU care for most neonates is provided by health-care professionals with little participation of the parents. An exception to this rule is the level 2 "Room-In" ward in Qilu Children's Hospital, Shandong University, where parents have 24-hour access to their infants and participate in providing care. METHODS This retrospective cohort study compared the outcomes of infants who were admitted to the NICU and remained there throughout their stay (NICU-NICU group, n=428), admitted to the NICU and then transferred to the Room-In ward (NICU-RIn group, n=1018), or admitted straight to the Room-In ward (RIn only group, n=629). RESULTS There were no significant differences in the rates of nosocomial infection, bronchopulmonary dysplasia, intraventricular hemorrhage, and retinopathy of prematurity between the NICU-NICU and NICU-RIn groups. The rate of necrotizing enterocolitis was significantly lower in the NICU-RIn group (P=0.04), while weight gain and duration of hospital stay were significantly higher (both P<0.001). Rates of adverse outcomes were lower in RIn-only infants due to their low severity of illness on admission. CONCLUSIONS Allowing parents access to their infant in the NICU is feasible and safe in China, and may result in improvements in infant outcomes. Further studies are required to generate stronger evidence that can inform changes to neonatal care in China.
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Hospital-acquired infection rate in a tertiary care teaching hospital in China: a cross-sectional survey involving 2434 inpatients. Int J Infect Dis 2014; 27:7-9. [DOI: 10.1016/j.ijid.2014.05.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 05/15/2014] [Accepted: 05/18/2014] [Indexed: 11/24/2022] Open
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Tian WX, Yu S, Ibrahim M, Almonaofy AW, He L, Hui Q, Bo Z, Li B, Xie GL. Copper as an antimicrobial agent against opportunistic pathogenic and multidrug resistant Enterobacter bacteria. J Microbiol 2012; 50:586-93. [DOI: 10.1007/s12275-012-2067-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 04/26/2012] [Indexed: 10/28/2022]
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Abbott IJ, Slavin MA, Turnidge JD, Thursky KA, Worth LJ. Stenotrophomonas maltophilia: emerging disease patterns and challenges for treatment. Expert Rev Anti Infect Ther 2011; 9:471-88. [PMID: 21504403 DOI: 10.1586/eri.11.24] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Stenotrophomonas maltophilia is a ubiquitous organism associated with opportunistic infections. In the immunocompromised host, increasing prevalence and severity of illness is observed, particularly opportunistic bloodstream infections and pneumonia syndromes. In this article, the classification and microbiology are outlined, together with clinical presentation, outcomes and management of infections due to S. maltophilia. Although virulence mechanisms and the genetic basis of antibiotic resistance have been identified, a role for standardized and uniform reporting of antibiotic sensitivity is not defined. Infections due to S. maltophilia have traditionally been treated with trimethoprim-sulfamethoxazole, ticarcillin-clavulanic acid, or fluoroquinolone agents. The use of combination therapies, newer fluoroquinolone agents and tetracycline derivatives is discussed. Finally, measures to prevent transmission of S. maltophilia within healthcare facilities are reported, especially in at-risk patient populations.
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Affiliation(s)
- Iain J Abbott
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.
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