A routine prospective survey process to detect nosocomial bacterial colonization in a neonatal unit: risk factors for acquisition

A systematic analysis of weekly nasal and rectal swabs was carried out in a neonatal unit in order to detect colonization with multiresistant bacteria (MRB). During a 6-month period, rectal and nasal samples were taken in 187 consecutively hospitalized newborns, the day of the admission (day 0) and...

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Published in:Archives de pédiatrie : organe officiel de la Société française de pédiatrie 2004-11, Vol.11 (11), p.1314-1318
Main Authors: Campeotto, F, Garnier, F, Kalach, N, Soulaines, P, Dupont, C, Raymond, J
Format: Article
Language:fre
Subjects:
Age Factors
Cross Infection
Drug Resistance, Multiple
Gram-Negative Bacteria - isolation & purification
Gram-Negative Bacterial Infections - transmission
Health Surveys
Humans
Infant Care - statistics & numerical data
Infant, Newborn
Odds Ratio
Prospective Studies
Staphylococcal Infections - transmission
Staphylococcus aureus - isolation & purification
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Summary:A systematic analysis of weekly nasal and rectal swabs was carried out in a neonatal unit in order to detect colonization with multiresistant bacteria (MRB). During a 6-month period, rectal and nasal samples were taken in 187 consecutively hospitalized newborns, the day of the admission (day 0) and every week until discharge, in order to detect MRB, mainly methicillin-resistant coagulase negative staphylococci (MRCoNS), Staphylococcus aureus and multi-resistant Gram-negative bacilli. Among 187 infants, 50 were already colonized at entrance and excluded from the study. In others, 49 (35%) were colonized by at least one MRB, with a total of 71 strains isolated. The most frequent was MRCoNS, especially Staphylococcus epidermidis (66.1%). Gram-negative bacilli accounted for 9.8%. Colonization began earlier with MRCoNS than with Gram-negative bacilli, 7.8 +/- 6 vs. 15.5 +/- 16 days, P=0.004, and finished earlier 22.7 +/- 15 vs. 38.5 +/- 16 days, P=0.03. Colonized children exhibited by univariate analysis a lower birth weight, more frequent parenteral nutrition or previous hospitalization in a neonatal unit and a younger age at admission. Odds ratio for colonization were 4.06 for prematurity and 43.83 for a previous hospitalization. MRCoNS at days 15 (P
ISSN:0929-693X
DOI:10.1016/j.arcped.2004.05.020