PDF(Pubmed)
Abstract：
BACKGROUND: Bacterial organisms causing neonatal sepsis have developed increased resistance to commonly used antibiotics. Antimicrobial resistance is a major global health problem. The spread of Multidrug-Resistant Organisms (MDROs) is associated with higher morbidity and mortality rates. This study aimed to determine the risk factors for developing MDRO neonatal sepsis in the Neonatal Intensive Care Unit (NICU), dr. Ramelan Navy Central Hospital, in 2020-2022.
METHODS: A cross-sectional study was performed on 113 eligible neonates. Patients whose blood cultures were positive for bacterial growth and diagnosed with sepsis were selected as the study sample. Univariate and multivariate analysis with multiple logistic regression were performed to find the associated risk factors for developing multidrug-resistant organism neonatal sepsis. A p-value of < 0.05 was considered significant.
RESULTS: Multidrug-resistant organisms were the predominant aetiology of neonatal sepsis (91/113, 80.5%). The significant risk factors for developing MDRO neonatal sepsis were lower birth weight (OR: 1.607, 95% CI: 1.003 - 2.576, p-value: 0.049), history of premature rupture of the membrane (ProM) ≥ 18 (OR: 3.333, 95% CI: 2.047 - 5.428, p-value < 0.001), meconium-stained amniotic fluid (OR: 2.37, 95% CI: 1.512 - 3.717, p-value < 0.001), longer hospital stays (OR: 5.067, 95% CI: 2.912 - 8.815, p-value < 0.001), lower Apgar scores (OR: 2.25, 95% CI: 1.442 - 3.512, p-value < 0.001), and the use of respiratory support devices, such as invasive ventilation (OR: 2.687, 95% CI: 1.514 - 4.771, p-value < 0.001), and non-invasive ventilation (OR: 2, 95% CI: 1.097 - 3.645, p-value: 0.024).
CONCLUSIONS: Our study determined various risk factors for multidrug-resistance organism neonatal sepsis and underscored the need to improve infection control practices to reduce the existing burden of drug-resistant sepsis. Low-birth-weight, a maternal history of premature rupture of the membrane lasting more than 18 hours, meconium-stained amniotic fluid, longer hospital stays, a low Apgar score, and the use of ventilators were the risk factors for developing drug-resistant neonatal sepsis.
METHODS: A cross-sectional study was performed on 113 eligible neonates. Patients whose blood cultures were positive for bacterial growth and diagnosed with sepsis were selected as the study sample. Univariate and multivariate analysis with multiple logistic regression were performed to find the associated risk factors for developing multidrug-resistant organism neonatal sepsis. A p-value of < 0.05 was considered significant.
RESULTS: Multidrug-resistant organisms were the predominant aetiology of neonatal sepsis (91/113, 80.5%). The significant risk factors for developing MDRO neonatal sepsis were lower birth weight (OR: 1.607, 95% CI: 1.003 - 2.576, p-value: 0.049), history of premature rupture of the membrane (ProM) ≥ 18 (OR: 3.333, 95% CI: 2.047 - 5.428, p-value < 0.001), meconium-stained amniotic fluid (OR: 2.37, 95% CI: 1.512 - 3.717, p-value < 0.001), longer hospital stays (OR: 5.067, 95% CI: 2.912 - 8.815, p-value < 0.001), lower Apgar scores (OR: 2.25, 95% CI: 1.442 - 3.512, p-value < 0.001), and the use of respiratory support devices, such as invasive ventilation (OR: 2.687, 95% CI: 1.514 - 4.771, p-value < 0.001), and non-invasive ventilation (OR: 2, 95% CI: 1.097 - 3.645, p-value: 0.024).
CONCLUSIONS: Our study determined various risk factors for multidrug-resistance organism neonatal sepsis and underscored the need to improve infection control practices to reduce the existing burden of drug-resistant sepsis. Low-birth-weight, a maternal history of premature rupture of the membrane lasting more than 18 hours, meconium-stained amniotic fluid, longer hospital stays, a low Apgar score, and the use of ventilators were the risk factors for developing drug-resistant neonatal sepsis.
摘要：
背景：引起新生儿败血症的细菌对常用抗生素的耐药性增加。抗菌素耐药性是一个重大的全球健康问题。多药耐药生物体（MDROs）的传播与较高的发病率和死亡率有关。本研究旨在确定新生儿重症监护病房（NICU）发生MDRO新生儿败血症的危险因素。dr.拉梅兰海军中心医院,2020-2022年。
方法：对113例符合条件的新生儿进行了横断面研究。选择血液培养细菌生长阳性并诊断为败血症的患者作为研究样品。采用单因素和多因素分析和多因素多因素多因素多因素回归分析新生儿发生多药耐药菌败血症的相关危险因素。<0.05的p值被认为是显著的。
结果：多重耐药菌是新生儿败血症的主要病因（91/113，80.5%）。发生MDRO新生儿败血症的重要危险因素是较低的出生体重（OR：1.607，95％CI：1.003-2.576，p值：0.049），胎膜早破病史(ProM)≥18(OR:3.333,95%CI:2.047-5.428,p值<0.001),羊水粪染(OR:2.37,95%CI:1.512-3.717,p值<0.001),住院时间更长（OR：5.067，95%CI：2.912-8.815，p值<0.001），较低的Apgar评分（OR：2.25，95%CI：1.442-3.512，p值<0.001），以及呼吸支持设备的使用，例如有创通气（OR：2.687，95%CI：1.514-4.771，p值<0.001），和无创通气（OR：2，95％CI：1.097-3.645，p值：0.024）。
结论：我们的研究确定了多药耐药菌新生儿败血症的各种危险因素，并强调需要改进感染控制实践，以减少现有的耐药脓毒症负担。低出生体重,母亲有超过18小时的胎膜早破病史，羊水胎粪污染,住院时间更长，阿普加分数很低,呼吸机的使用是耐药新生儿败血症发生的危险因素。
方法：对113例符合条件的新生儿进行了横断面研究。选择血液培养细菌生长阳性并诊断为败血症的患者作为研究样品。采用单因素和多因素分析和多因素多因素多因素多因素回归分析新生儿发生多药耐药菌败血症的相关危险因素。<0.05的p值被认为是显著的。
结果：多重耐药菌是新生儿败血症的主要病因（91/113，80.5%）。发生MDRO新生儿败血症的重要危险因素是较低的出生体重（OR：1.607，95％CI：1.003-2.576，p值：0.049），胎膜早破病史(ProM)≥18(OR:3.333,95%CI:2.047-5.428,p值<0.001),羊水粪染(OR:2.37,95%CI:1.512-3.717,p值<0.001),住院时间更长（OR：5.067，95%CI：2.912-8.815，p值<0.001），较低的Apgar评分（OR：2.25，95%CI：1.442-3.512，p值<0.001），以及呼吸支持设备的使用，例如有创通气（OR：2.687，95%CI：1.514-4.771，p值<0.001），和无创通气（OR：2，95％CI：1.097-3.645，p值：0.024）。
结论：我们的研究确定了多药耐药菌新生儿败血症的各种危险因素，并强调需要改进感染控制实践，以减少现有的耐药脓毒症负担。低出生体重,母亲有超过18小时的胎膜早破病史，羊水胎粪污染,住院时间更长，阿普加分数很低,呼吸机的使用是耐药新生儿败血症发生的危险因素。
