Abstract:
BACKGROUND:In 2013 German infection surveillance guidelines recommended weekly colonization screening for multidrug-resistant (MDRO) or highly epidemic organisms for neonatal intensive care units (NICUs) and extended hygiene measures based on screening results. It remains a matter of debate whether screening is worth the effort. We therefore aimed to evaluate sepsis related outcomes before and after the guideline update. METHODS:The German Neonatal Network (GNN) is a prospective cohort study including data from extremely preterm infants between 22 + 0 and 28 + 6 gestational weeks born in 62 German level III NICUs. RESULTS:Infants treated after guideline update (n = 8.903) had a lower mortality (12.5% vs. 13.8%, p = 0.036), reduced rates for clinical sepsis (31.4 vs. 42.8%, p < 0.001) and culture-proven sepsis (14.4% vs. 16.5%, p = 0.003) as compared to infants treated before update (n = 3.920). In a multivariate logistic regression analysis, nine pathogens of culture-proven sepsis were associated with sepsis-related death, e.g. Pseudomonas aeruginosa [OR 59 (19-180), p < 0.001)]. However, the guideline update had no significant effect on pathogen-specific case fatality, total sepsis-related mortality and culture-proven sepsis rates with MDRO. While the exposure of GNN infants to cefotaxime declined over time (31.1 vs. 40.1%, p < 0.001), the treatment rate with meropenem was increased (31.6 vs. 26.3%, p < 0.001). CONCLUSIONS:The introduction of weekly screening and extended hygiene measures is associated with reduced sepsis rates, but has no effects on sepsis-related mortality and sepsis with screening-relevant pathogens. The high exposure rate to meropenem should be a target of antibiotic stewardship programs.
journal_name
Antimicrob Resist Infect Controljournal_title
Antimicrobial resistance and infection controlauthors
Härtel C,Faust K,Fortmann I,Humberg A,Pagel J,Haug C,Kühl R,Bohnhorst B,Pirr S,Viemann D,Simon A,Zemlin M,Poralla S,Müller A,Köstlin-Gille N,Gille C,Heckmann M,Rupp J,Herting E,Göpel Wdoi
10.1186/s13756-020-00804-8subject
Has Abstractpub_date
2020-08-26 00:00:00pages
144issue
1issn
2047-2994pii
10.1186/s13756-020-00804-8journal_volume
9pub_type
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-015-0100-5
更新日期:2016-01-05 00:00:00
abstract:OBJECTIVE:To determine the effect of exposure to remnants of a phagemid-containing E. coli, killed by treatment with a propanol-based hand rub, on antimicrobial resistance in E. coli isolates. METHODS:An in vitro model was developed in which a clinical E. coli isolate (EUR1) was exposed to remnants of an E. coli K-12 ...
journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-020-00708-7
更新日期:2020-03-16 00:00:00
abstract:BACKGROUND:Very low birthweight (VLBW) newborns on neonatal intensive care units (NICU) are at increased risk for developing central venous catheter-associated bloodstream infections (CVC BSI). In addition to the established intrinsic risk factors of VLBW newborns, it is still not clear which process and structure para...
journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/2047-2994-2-11
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-018-0416-z
更新日期:2018-10-11 00:00:00
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journal_title:Antimicrobial resistance and infection control
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doi:10.1186/s13756-019-0616-1
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abstract:Background:Dispensary and use of antibiotics without prescriptions from qualified providers is a common practice in countries with poor pharmaceutical regulations and where due focus is not given to rational use. This practice is a main factor for the spread of antimicrobial resistance due to its non-reliance on pre-tr...
journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章,多中心研究
doi:10.1186/s13756-019-0571-x
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journal_title:Antimicrobial resistance and infection control
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
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journal_title:Antimicrobial resistance and infection control
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journal_title:Antimicrobial resistance and infection control
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doi:10.1186/s13756-018-0455-5
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journal_title:Antimicrobial resistance and infection control
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abstract:BACKGROUND:Mcr-1-harboring Enterobacteriaceae are reported worldwide since their first discovery in 2015. However, a limited number of studies are available that compared full-length plasmid sequences of human and animal origins. METHODS:In this study, mcr-1-bearing plasmids from seven Escherichia coli isolates recove...
journal_title:Antimicrobial resistance and infection control
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doi:10.1186/s13756-017-0250-8
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abstract:UNLABELLED: BACKGROUND:Antimicrobial stewardship has been promoted as a key strategy for coping with the problems of antimicrobial resistance and Clostridium difficile. Despite the current call for stewardship in community hospitals, including smaller community hospitals, practical examples of stewardship programs are...
journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/2047-2994-3-9
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journal_title:Antimicrobial resistance and infection control
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doi:10.1186/s13756-018-0397-y
更新日期:2018-08-29 00:00:00
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/2047-2994-2-28
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
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abstract:Background:The global rise and spread of antibiotic resistance is limiting the usefulness of antibiotics in the prevention and treatment of infectious diseases. The use of antibiotic stewardship programs guided by local data on prescribing practices is a useful strategy to control and reduce antibiotic resistance. Our ...
journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
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journal_title:Antimicrobial resistance and infection control
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journal_title:Antimicrobial resistance and infection control
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pub_type: 信件
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-020-00755-0
更新日期:2020-06-16 00:00:00
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-019-0464-z
更新日期:2019-01-15 00:00:00
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-018-0337-x
更新日期:2018-04-03 00:00:00
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-019-0485-7
更新日期:2019-02-12 00:00:00
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-017-0238-4
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-017-0284-y
更新日期:2017-12-13 00:00:00
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-017-0184-1
更新日期:2017-03-11 00:00:00
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-017-0249-1
更新日期:2017-09-19 00:00:00
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
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更新日期:2020-08-26 00:00:00