Please use this identifier to cite or link to this item: doi:10.22028/D291-41111
Title: Sepsis related mortality of extremely low gestational age newborns after the introduction of colonization screening for multi-drug resistant organisms
Author(s): Härtel, Christoph
Faust, Kirstin
Fortmann, Ingmar
Humberg, Alexander
Pagel, Julia
Haug, Clara
Kühl, Reinhard
Bohnhorst, Bettina
Pirr, Sabine
Viemann, Dorothee
Simon, Arne
Zemlin, Michael
Poralla, Silvia
Müller, Andreas
Köstlin-Gille, Natascha
Gille, Christian
Heckmann, Matthias
Rupp, Jan
Herting, Egbert
Göpel, Wolfgang
Language: English
Title: Antimicrobial Resistance and Infection Control
Volume: 9
Issue: 1
Publisher/Platform: BMC
Year of Publication: 2020
Free key words: Colonization screening
Multi-drug resistant organisms
Extremely preterm infants
Sepsis mortality
Preterm infant
DDC notations: 610 Medicine and health
Publikation type: Journal Article
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 cultureproven 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.
DOI of the first publication: 10.1186/s13756-020-00804-8
URL of the first publication:
Link to this record: urn:nbn:de:bsz:291--ds-411115
ISSN: 2047-2994
Date of registration: 17-Nov-2023
Description of the related object: Supplementary information
Related object:
Faculty: M - Medizinische Fakultät
Department: M - Pädiatrie
Professorship: M - Prof. Dr. Michael Zemlin
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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