Wang, J; Kortsalioudaki, C; Heath, PT; Buttery, J; Clarke, P; Gkentzi, D; Anthony, M; Tan, K; neonIN network
(2019)
Epidemiology and healthcare factors associated with neonatal enterococcal infections.
Arch Dis Child Fetal Neonatal Ed, 104 (5).
F480-F485.
ISSN 1468-2052
https://doi.org/10.1136/archdischild-2018-315387
SGUL Authors: Heath, Paul Trafford
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Abstract
OBJECTIVE: To investigate the epidemiology and healthcare factors associated with late-onset neonatal enterococcal infections. DESIGN: Multicentre, multinational retrospective cohort study using prospectively collected infection data from a neonatal infection surveillance network between 2004 and 2016; this was supplemented with healthcare data from a questionnaire distributed to participating neonatal units. SETTING: Sixty neonatal units across Europe (UK, Greece, Estonia) and Australia. PATIENTS: Infants admitted to participating neonatal units who had a positive culture of blood, cerebrospinal fluid or urine after 48 hours of life. RESULTS: In total, 414 episodes of invasive Enterococcus spp infection were reported in 388 infants (10.1% of a total 4083 episodes in 3602 infants). Enterococcus spp were the second most common cause of late-onset infection after coagulase-negative Staphylococcus spp and were strongly associated with necrotising enterocolitis (NEC) (adjusted OR 1.44, 95% CI 1.02 to 2.03, p=0.038), total parenteral nutrition (TPN) (adjusted OR 1.34, 95% CI 1.06 to 1.70, p=0.016), increasing postnatal age (per 1-week increase: adjusted OR 1.04, 95% CI 1.02 to 1.06, p<0.001) and decreasing birth weight (per 1 kg increase: adjusted OR 0.85, 95% CI 0.74 to 0.97, p=0.017). There was no evidence that inadequate nurse to patient staffing ratios in high-dependency units were associated with a higher risk of enterococcal infections. CONCLUSIONS: Enterococcus spp were the second most frequent cause of late-onset infections. The association between enterococcal infections, NEC and TPN may inform empiric antimicrobial regimens in these contexts and provide insights into reducing these infections.
Item Type: | Article | ||||||||
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Additional Information: | This article has been accepted for publication in ADC Fetal and Neonatal Edition, 2018 following peer review, and the Version of Record can be accessed online at http://dx.doi.org/10.1136/archdischild-2018-315387. © Author(s) (or their employer(s)) 2018. | ||||||||
Keywords: | enterococcus, epidemiology, healthcare, infection, neonatal, neonIN network, enterococcus, epidemiology, healthcare, infection, neonatal, 1114 Paediatrics And Reproductive Medicine, Pediatrics | ||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Infection and Immunity Research Institute (INII) | ||||||||
Journal or Publication Title: | Arch Dis Child Fetal Neonatal Ed | ||||||||
ISSN: | 1468-2052 | ||||||||
Language: | eng | ||||||||
Dates: |
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Publisher License: | Publisher's own licence | ||||||||
PubMed ID: | 30425112 | ||||||||
Go to PubMed abstract | |||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/110437 | ||||||||
Publisher's version: | https://doi.org/10.1136/archdischild-2018-315387 |
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