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| |  Study Identifies Risk Factors for ESBL-Producing Enterobacteriaceae Colonisation in Newborns: Presented at ESPID By Lynda Jackson BRUSSELS, Belgium -- June 16, 2009 -- Lower gestational age, birth weight, and more invasive therapeutic procedures lead to longer stays in the Neonatal Intensive Care Units (NICUs) and are significantly associated with extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae colonisation. Voker Strenger, MD, Department of Paediatrics and Adolescent Medicine, Medical University Graz, Graz, Austria, presented a poster on behalf of his Study Group here at the 26th Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID) on June 11. The researchers retrospectively analysed risk factors associated with ESBL-producing Enterobacteriacaea colonisation in newborns hospitalised at the NICU during January 2005 to July 2008. The infants were screened routinely (at least twice a week) for ESBL-producing bacteria in stool. Of the 1,164 newborns included in the study, 69 (5.9%) were colonised with ESBL-producing Klebsiella pneumoniae (n = 51), Klebsiella oxytoca (n = 11), Serratia marcescens (n = 6), and Escherichia coli (n = 1). Significant differences were noted between colonised and noncolonised infants for all factors analysed, except sex. Of the noncolonised infants, 65.0% (n = 712/1,095) were born via caesarean section and 79.7% of the colonised infants (n = 55/69) were born via caesarean section. In the noncolonised infants, baby’s Apgar score at 1 minute was <9 in 51.4% compared with 82.6% of the colonised newborns (P < .001). Apgar score at 5 minutes was <10 in 50.7% of the noncolonised infants compared with 78.3% of the colonised infants (P < .001). And Apgar score at 10 minutes was <10 in 39.0% of noncolonised newborns compared with 71.0% of colonised newborns (P < .001). In all, 33.4% of the noncolonised infants received respiratory therapy compared with 63.8% of the colonised newborns (P < .001); and 32.2% of noncolonised infants, compared with 53.6% of those in the colonised group, received continuous positive airway pressure (CPAP) therapy (P = .001). Median gestational age of noncolonised newborns was 35 weeks (range, 23-43 weeks) compared with a median 31 weeks (range, 24-40 weeks) in colonised infants (P < .001). Median birth weight was 2365 g (range, 400-5215 g) in noncolonised newborns compared with a median weight of 1415 g (range, 540-3834 g) in colonised infants (P < .001). The researchers used cefuroxime and ampicillin as first-line antibiotics. Third-generation cephalosporines were not used during the observation period. Dr. Strenger noted that ESBL gene expression might be induced under therapy with second-generation cephalosporines. [Presentation title: Extended-Spectrum Beta-Lactamase (ESBL)-Producing Enterobacteria-Risk Factors for Intestinal Colonization at the Neonatal Intensive Care Unit (NICU). Abstract P018]
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