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 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: | https://aricjournal.biomedcentral.com/articles/10.1186/s13756-020-00804-8 |
Link to this record: | urn:nbn:de:bsz:291--ds-411115 hdl:20.500.11880/36894 http://dx.doi.org/10.22028/D291-41111 |
ISSN: | 2047-2994 |
Date of registration: | 17-Nov-2023 |
Description of the related object: | Supplementary information |
Related object: | https://static-content.springer.com/esm/art%3A10.1186%2Fs13756-020-00804-8/MediaObjects/13756_2020_804_MOESM1_ESM.docx https://static-content.springer.com/esm/art%3A10.1186%2Fs13756-020-00804-8/MediaObjects/13756_2020_804_MOESM2_ESM.docx |
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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s13756-020-00804-8.pdf | 549,51 kB | Adobe PDF | View/Open |
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