Multidrug-resistant Gram-negative bacteria rate and risk factors in the neonatal intensive care unit: A single-center ten-year experience

Authors : Hatice Mine ÇAKMAK, Dilek YEKENKURUL, Zehra ŞENGÜN, Selvi YENER, Pelin DURAN, Fatih DAVRAN, Kenan KOCABAY

Pages : 228-235

Doi:10.18521/ktd.1265336

View : 34 | Download : 30

Publication Date : 2023-06-22

Article Type : Research Paper

Abstract :Objective: Multidrug resistance insert ignore into journalissuearticles values(MDR); in gram-negative neonatal infections is difficult to manage, and the risk factors differ among different studies. We aim to investigate the demographics, mortality, MDR status of gram-negative isolates, and risk factors for MDR gram-negative infections. Material-Methods: We conducted a retrospective single-center study about MDR gram-negative infections in neonates between January 2012-January 2022 at Duzce University Hospital in Turkey. This study evaluates neonates with MDR gram-negative infections\` risk factors and clinical features. All analyses were performed using IBM SPSS V23. Univariate analyses and multivariate logistic regression models were studied to determine MDR\`s risk factors. Results: Of 107 gram-negative bacteria, 41 insert ignore into journalissuearticles values(38.3%); accounted for Enterobacter, 30 insert ignore into journalissuearticles values(28%); for Klebsiella pneumonia, and 22 insert ignore into journalissuearticles values(20.6%); for Escherichia coli. Additionally, 61 insert ignore into journalissuearticles values(56.5%); were MDR microorganisms. Among the susceptibility tests performed for selected isolates, 41 insert ignore into journalissuearticles values(77.4%); had resistance to Piperacillin, 57 insert ignore into journalissuearticles values(75%); showed resistance to amoxiclav, and 16 insert ignore into journalissuearticles values(72.7%); had cefoxitin resistance. In addition, carbapenemase resistance was found in 24 insert ignore into journalissuearticles values(43.6%); and meropenem resistance in 13 insert ignore into journalissuearticles values(36.1%);. Colistin, aztreonam, and tigecycline resistances were the least frequent. The following dependent risk factors increased the multidrug resistance risk in gram-negative infections; late-onset sepsis 3.547 fold insert ignore into journalissuearticles values(p=0.005);, use of mechanical ventilation 3.143 fold insert ignore into journalissuearticles values(p=0.007);, blood culture positivity 3.587-fold insert ignore into journalissuearticles values(p=0.013);, bronchopulmonary dysplasia 6.702 fold, insert ignore into journalissuearticles values(p= 0.015); and total parenteral nutrition 5.591 fold insert ignore into journalissuearticles values(p=0.001);, lower gestational age 1.122 insert ignore into journalissuearticles values(1/0.891); fold insert ignore into journalissuearticles values(p=0.026);, and birth weight 1.001 insert ignore into journalissuearticles values(1/0.999); fold, insert ignore into journalissuearticles values(p=0.013);. Similarly, anti-biotherapy duration was significantly higher in the MDR group than in the non-MDR group. Conclusions: The reported risk factors for MDR in gram-negative neonatal infections are all dependent risk factors. Hence clinicians must be alert to all potential risk factors.
Keywords : gram negatif bakteriyel enfeksiyonlar, yenidoğanlar, çoklu ilaç direnci