การติดเชื้อในเลือดและหรือเยื่อหุ้มสมองจากเชื้อแบคทีเรียแกรมลบที่ดื้อยาหลายชนิดในหออภิบาลทารกแรกเกิด : การศึกษาที่มีกลุ่มควบคุม

Abstract

objective:%20To%20identified%20the%20risks%20and%20outcomes%20of%20multidrug-resistant%20Gram-negative%20bacilli%20(MDRGNB)%20sepsis%20in%20neonates.%0AMethods%3A%20A%20retrospective%20case-case-control%20study%20was%20performed%20between%201991%20and%0A2016.%20The%20control%20group%20was%20select%20from%20the%20same%20source%20records%20of%20all%20neonates%20with%20clinical%20or%20suspected%20sepsis%20but%20not%20culture-proven,%20and%20from%20whom%20blood%20and/or%20cerebrospinal%20fluid%20cultures%20had%20been%20obtained%201%20day%20prior%20to,%20the%20same%20day,%20and%201%20day%20after%20the%20date%20of%20positive%20cultures%20of%20all%20identified%20case%20patients.%0AResults:%20The%20numbers%20of%20patients%20in%20the%20MDRGNB%20sepsis,%20non-MDRGNB%20sepsis,%20and%20control%20group%20were%20157,%2088%20and%20218,%20respectively.%20MDRGNB%20sepsis%20was%20significantly%20associated%20with%20outborn%20infants%20%5Badjust%20odd%20ratio%20(aOR)%202.08;%20P=0.003%5D%20and%20infant%20who%20had%20a%20lower%20gestational%20age%20(P=0.03),%20neurologic%20sequelae%20(aOR%2011.58;%20P=0.04),%20or%20previous%20aminoglycoside%20use%20(aOR%202.43;%20P%3C0.001)%20compared%20with%20the%20control%20group.%0AMDRGNB%20sepsis%20was%20associated%20with%20infant%20who%20had%20a%20lower%20gestational%20age%20(aOR%200.89;%0AP%3C0.001),%20and%20lower%20weight%20at%20onset%20of%20sepsis%20(aOR%201.00;%20P=0.01)%20compared%20with%20the%20non-MDRGNB%20group.%20Case%20fatality%20(aOR%203.63;%20P%3C0.001)%20and%20septic%20shock%20rates%20(aOR%0A12.81;%20P%3C0.001),%20length%20of%20stay%20(P%3C0.001),%20and%20daily%20hospital%20costs%20(P=0.01)%20were%20higher%20in%20the%20MDRGNB%20sepsis%20group%20than%20in%20the%20control%20group.%0AConclusions:%20Outborn%20neonates,%20infant%20who%20had%20a%20lower%20gestational%20age,%20neurological%20sequelae,%20and%20previous%20aminoglycoside%20use%20were%20associated%20with%20MDRGNB%20compared%20with%20the%20control%20group.%20Higher%20mortality,%20longer%20length%20of%20stay,%20and%20higher%20daily%20cost%20were%20associated%20with%20MDRGNB%20sepsis.