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South African study highlights threat of deadly multidrug-resistant infections in low-birthweight infants
News brief
3 minutes ago.
Chris Dall, MA
Topics
Antimicrobial Stewardship
A study conducted at a neonatal unit in South Africa found that one third of late-onset sepsis (LOS) cases in very-low-birthweight (VLBW) infants were caused by multidrug-resistant organisms (MDROs), 41% of which proved fatal, researchers reported yesterday in Open Forum Infectious Diseases.
For the study, a team of US and South African researchers analyzed data on VLBW infants who were admitted to Charlotte Maxeke Academic Hospital in Johannesburg from March 2015 to December 2020. The data collected included demographic and clinical characteristics, length of hospital stay, risk factors for MDRO infection and mortality, and microbiology results.
Of 2,570 VLBW infants admitted during the study period, 869 (34%) were characterized as having LOS, and 287 (33%) LOS cases were caused by an MDRO. Of the infants with LOS caused by an MDRO, 119 (41%) died during their hospitalization. The highest mortality occurred among patients infected with gram-negative bacteria. The pathogens with the highest mortality rates were Acinetobacter spp. (53%), Pseudomonas spp. (45%), extended-spectrum beta-lactamase Klebsiella spp. (43%), and Escherichia coli (42%).
Research efforts should prioritize the development of new antibiotics and should include the neonatal population in the dosing evaluations.
Multivariate logistic regression analysis showed that infants with congenital infections (adjusted odds ratio [aOR], 5.13; 95% confidence interval [CI], 1.19 to 22.02) or history of necrotizing enterocolitis (aOR, 2.17; 95% CI, 1.05 to 4.49) were at significantly higher risk for MDRO infections, likely because of exposure to prolonged antimicrobial therapy during hospitalization.
Serious challenge in developing nations
The study authors say the findings highlight the serious challenge that MDROs pose to neonatal intensive care units in developing countries.
"Antimicrobial stewardship programs, infection control protocols, ongoing surveillance, rapid diagnostic tests, and novel treating agents for MDRO are crucial," they wrote. "Research efforts should prioritize the development of new antibiotics and should include the neonatal population in the dosing evaluations needed for these efforts to impact the MDRO burden among these infants."
South African study highlights threat of deadly multidrug-resistant infections in low-birthweight infants
News brief
3 minutes ago.
Chris Dall, MA
Topics
Antimicrobial Stewardship
A study conducted at a neonatal unit in South Africa found that one third of late-onset sepsis (LOS) cases in very-low-birthweight (VLBW) infants were caused by multidrug-resistant organisms (MDROs), 41% of which proved fatal, researchers reported yesterday in Open Forum Infectious Diseases.
For the study, a team of US and South African researchers analyzed data on VLBW infants who were admitted to Charlotte Maxeke Academic Hospital in Johannesburg from March 2015 to December 2020. The data collected included demographic and clinical characteristics, length of hospital stay, risk factors for MDRO infection and mortality, and microbiology results.
Of 2,570 VLBW infants admitted during the study period, 869 (34%) were characterized as having LOS, and 287 (33%) LOS cases were caused by an MDRO. Of the infants with LOS caused by an MDRO, 119 (41%) died during their hospitalization. The highest mortality occurred among patients infected with gram-negative bacteria. The pathogens with the highest mortality rates were Acinetobacter spp. (53%), Pseudomonas spp. (45%), extended-spectrum beta-lactamase Klebsiella spp. (43%), and Escherichia coli (42%).
Research efforts should prioritize the development of new antibiotics and should include the neonatal population in the dosing evaluations.
Multivariate logistic regression analysis showed that infants with congenital infections (adjusted odds ratio [aOR], 5.13; 95% confidence interval [CI], 1.19 to 22.02) or history of necrotizing enterocolitis (aOR, 2.17; 95% CI, 1.05 to 4.49) were at significantly higher risk for MDRO infections, likely because of exposure to prolonged antimicrobial therapy during hospitalization.
Serious challenge in developing nations
The study authors say the findings highlight the serious challenge that MDROs pose to neonatal intensive care units in developing countries.
"Antimicrobial stewardship programs, infection control protocols, ongoing surveillance, rapid diagnostic tests, and novel treating agents for MDRO are crucial," they wrote. "Research efforts should prioritize the development of new antibiotics and should include the neonatal population in the dosing evaluations needed for these efforts to impact the MDRO burden among these infants."