Multidrug-resistant Gram-negative bacilli sepsis from a neonatal intensive care unit: a case-case-control study

Anucha Thatrimontrichai; Nutchana Premprat; Waricha Janjindamai; Supaporn Dissaneevate; Gunlawadee Maneenil

doi:10.3855/jidc.10402

Multidrug-resistant Gram-negative bacilli sepsis from a neonatal intensive care unit: a case-case-control study

Authors

Anucha Thatrimontrichai Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
Nutchana Premprat Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
Waricha Janjindamai Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
Supaporn Dissaneevate Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
Gunlawadee Maneenil Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand

DOI:

https://doi.org/10.3855/jidc.10402

Keywords:

bacteremia, Gram-negative bacteria, meningitis, multiple drug resistance, neonatal sepsis, neonate

Abstract

Introduction: To identify the risks and outcomes for multidrug-resistant Gram-negative bacilli (MDRGNB) sepsis in neonates.

Methodology: This was a retrospective case-case-control study between 1991 and 2016. The control group was selected from the same source records of all neonates with clinical or suspected sepsis but not culture-proven.

Results: The numbers of patients in the MDRGNB sepsis, non-MDRGNB sepsis, and control groups were 157, 88, and 218, respectively. MDRGNB sepsis was significantly associated with outborn infants [adjusted odds ratio (aOR) 2.08; p = 0.003] and infants who had a neurologic sequela (aOR 11.58; p = 0.04), lower gestational age (p = 0.03) or previous aminoglycoside use (aOR 2.43; p < 0.001) compared with the control group. Non-MDRGNB sepsis was associated with outborn infants (aOR 2.63; p < 0.001), and infants who had neurologic sequelae (aOR 48.25; p = 0.001) and previous cephalosporin use (aOR 6.28; p < 0.001) or cefoperazone plus sulbactam use (aOR 6.48; p = 0.02) compared with the control group. Case fatality (OR 3.63; p < 0.001) and septic shock (OR 12.81; p < 0.001) rates, length of stay (p < 0.001), and daily hospital costs (p = 0.01) were higher in the MDRGNB sepsis group than in the control group.

Conclusions: Smaller preterm neonate with previous aminoglycoside use had a higher MDRGNB than non-MDRGNB sepsis compared with the control group. Intervention to reduce MDRGNB sepsis in the NICU is cost-effective.

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Published

2019-07-31

How to Cite

Thatrimontrichai A, Premprat N, Janjindamai W, Dissaneevate S, Maneenil G (2019) Multidrug-resistant Gram-negative bacilli sepsis from a neonatal intensive care unit: a case-case-control study. J Infect Dev Ctries 13:603–611. doi: 10.3855/jidc.10402

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Issue

Vol. 13 No. 07: July 2019

Section

Original Articles

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