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Epidemiology and healthcare factors associated with neonatal enterococcal infections.

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
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:
DateEvent
19 August 2019Published
13 November 2018Published Online
9 October 2018Accepted
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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