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Maternal Colonization Versus Nosocomial Transmission as the Source of Drug-Resistant Bloodstream Infection in an Indian Neonatal Intensive Care Unit: A Prospective Cohort Study.
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- Author(s): Robinson, Matthew L; Johnson, Julia; Naik, Shilpa; Patil, Sunil; Kulkarni, Rajesh; Kinikar, Aarti; Dohe, Vaishali; Mudshingkar, Swati; Kagal, Anju; Smith, Rachel M; Westercamp, Matthew; Randive, Bharat; Kadam, Abhay; Babiker, Ahmed; Kulkarni, Vandana; Karyakarte, Rajesh; Mave, Vidya; Gupta, Amita; Milstone, Aaron M; Manabe, Yukari C
- Source:
Clinical Infectious Diseases; 2023 Supplement, Vol. 77, pS38-S45, 8p- Subject Terms:
HOST-bacteria relationships; NEONATAL sepsis; NEONATAL intensive care; ACADEMIC medical centers; COMMUNICABLE diseases; GRAM-negative bacteria; CROSS infection; NEONATAL intensive care units; TERTIARY care; ANTI-infective agents; INFECTION control; HOSPITAL care; RESEARCH funding; GRAM-negative bacterial diseases; DRUG resistance in microorganisms; CARBAPENEMS; LONGITUDINAL method; DISEASE complications; PREGNANCY - Source:
- Additional Information
- Subject Terms:
- Abstract: Background Drug-resistant gram-negative (GN) pathogens are a common cause of neonatal sepsis in low- and middle-income countries. Identifying GN transmission patterns is vital to inform preventive efforts. Methods We conducted a prospective cohort study, 12 October 2018 to 31 October 2019 to describe the association of maternal and environmental GN colonization with bloodstream infection (BSI) among neonates admitted to a neonatal intensive care unit (NICU) in Western India. We assessed rectal and vaginal colonization in pregnant women presenting for delivery and colonization in neonates and the environment using culture-based methods. We also collected data on BSI for all NICU patients, including neonates born to unenrolled mothers. Organism identification, antibiotic susceptibility testing, and next-generation sequencing (NGS) were performed to compare BSI and related colonization isolates. Results Among 952 enrolled women who delivered, 257 neonates required NICU admission, and 24 (9.3%) developed BSI. Among mothers of neonates with GN BSI (n = 21), 10 (47.7%) had rectal, 5 (23.8%) had vaginal, and 10 (47.7%) had no colonization with resistant GN organisms. No maternal isolates matched the species and resistance pattern of associated neonatal BSI isolates. Thirty GN BSI were observed among neonates born to unenrolled mothers. Among 37 of 51 BSI with available NGS data, 21 (57%) showed a single nucleotide polymorphism distance of ≤5 to another BSI isolate. Conclusions Prospective assessment of maternal GN colonization did not demonstrate linkage to neonatal BSI. Organism-relatedness among neonates with BSI suggests nosocomial spread, highlighting the importance of NICU infection prevention and control practices to reduce GN BSI. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Clinical Infectious Diseases is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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