Abstract：
The aim of this study was to compare sequelae and acute kidney injury (AKI) occurrence among patients with necrotizing enterocolitis (NEC) after changing institutional guidelines replacing vancomycin with ampicillin for gram-positive coverage. This was a retrospective, single-center cohort analysis of patients from 2016-2020 (n = 73) with NEC at a surgical neonatal intensive care unit with a high community prevalence of methicillin-resistant Staphylococcus aureus (MRSA). Multivariate logistic regression was utilized to assess associations. Twenty-five (34%) patients had at least 1 sequela related to NEC. Ampicillin containing regimens were not associated with any sequelae type or AKI. Postmenstrual age < 29 weeks at diagnosis ([OR] 5.8 [1.2-28.8], P = .03; and receipt of vasopressors [OR] 3.3 [1.1-10.2], P = .04) were independently associated with sequalae. Stage III NEC was independently associated with AKI, OR 10.6 (2-55.6), P = .005. In conclusion, ampicillin-containing regimens are effective for NEC management at our institution despite a high prevalence of MRSA.
摘要：
这项研究的目的是比较坏死性小肠结肠炎（NEC）患者的后遗症和急性肾损伤（AKI）的发生，这些患者改变了机构指南，用氨苄西林代替万古霉素以进行革兰氏阳性覆盖。这是一次回顾,对社区耐甲氧西林金黄色葡萄球菌(MRSA)患病率较高的外科新生儿重症监护病房2016-2020年NEC患者(n=73)进行单中心队列分析.多变量逻辑回归用于评估相关性。25例（34％）患者至少有1例与NEC相关的后遗症。含氨苄西林的方案与任何后遗症类型或AKI无关。诊断时月经后年龄<29周（[OR]5.8[1.2-28.8]，P=.03;和接收血管加压药[OR]3.3[1.1-10.2]，P=.04）与后遗症独立相关。III期NEC与AKI独立相关，或10.6（2-55.6），P=.005。总之,尽管MRSA的患病率很高,但在我们机构,含氨苄青霉素的方案对于NEC管理是有效的。
