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Neonatal multidrug resistant gram-negative infection: epidemiology, mechanisms of resistance, and management
Infants admitted to the neonatal intensive care unit, particularly those born preterm, are at high risk for infection due to the combination of an immature immune system, prolonged hospitalization, and frequent use of invasive devices. Emerging evidence suggests that multidrug resistant gram-negativ...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8819496/ https://www.ncbi.nlm.nih.gov/pubmed/34599280 http://dx.doi.org/10.1038/s41390-021-01745-7 |
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author | Flannery, Dustin D. Chiotos, Kathleen Gerber, Jeffrey S. Puopolo, Karen M. |
author_facet | Flannery, Dustin D. Chiotos, Kathleen Gerber, Jeffrey S. Puopolo, Karen M. |
author_sort | Flannery, Dustin D. |
collection | PubMed |
description | Infants admitted to the neonatal intensive care unit, particularly those born preterm, are at high risk for infection due to the combination of an immature immune system, prolonged hospitalization, and frequent use of invasive devices. Emerging evidence suggests that multidrug resistant gram-negative (MDR-GN) infections are increasing in neonatal settings, which directly threatens recent and ongoing advances in contemporary neonatal care. A rising prevalence of antibiotic resistance among common neonatal pathogens compounds the challenge of optimal management of suspected and confirmed neonatal infection. We review the epidemiology of MDR-GN infections in neonates in the United States and internationally, with a focus on extended-spectrum β-lactamase (ESBL)-producing Enterobacterales and carbapenem-resistant Enterobacterales (CRE). We include published single center studies, neonatal collaborative reports, and national surveillance data. Risk factors for and mechanisms of resistance are discussed. Additionally, we discuss current recommendations for empiric antibiotic therapy for suspected infections, as well as definitive treatment options for key multidrug resistant organisms. Finally, we review best practices for prevention and identify current knowledge gaps and areas for future research. |
format | Online Article Text |
id | pubmed-8819496 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
record_format | MEDLINE/PubMed |
spelling | pubmed-88194962022-04-01 Neonatal multidrug resistant gram-negative infection: epidemiology, mechanisms of resistance, and management Flannery, Dustin D. Chiotos, Kathleen Gerber, Jeffrey S. Puopolo, Karen M. Pediatr Res Article Infants admitted to the neonatal intensive care unit, particularly those born preterm, are at high risk for infection due to the combination of an immature immune system, prolonged hospitalization, and frequent use of invasive devices. Emerging evidence suggests that multidrug resistant gram-negative (MDR-GN) infections are increasing in neonatal settings, which directly threatens recent and ongoing advances in contemporary neonatal care. A rising prevalence of antibiotic resistance among common neonatal pathogens compounds the challenge of optimal management of suspected and confirmed neonatal infection. We review the epidemiology of MDR-GN infections in neonates in the United States and internationally, with a focus on extended-spectrum β-lactamase (ESBL)-producing Enterobacterales and carbapenem-resistant Enterobacterales (CRE). We include published single center studies, neonatal collaborative reports, and national surveillance data. Risk factors for and mechanisms of resistance are discussed. Additionally, we discuss current recommendations for empiric antibiotic therapy for suspected infections, as well as definitive treatment options for key multidrug resistant organisms. Finally, we review best practices for prevention and identify current knowledge gaps and areas for future research. 2022-01 2021-10-01 /pmc/articles/PMC8819496/ /pubmed/34599280 http://dx.doi.org/10.1038/s41390-021-01745-7 Text en http://www.nature.com/authors/editorial_policies/license.html#termsUsers may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:http://www.nature.com/authors/editorial_policies/license.html#terms |
spellingShingle | Article Flannery, Dustin D. Chiotos, Kathleen Gerber, Jeffrey S. Puopolo, Karen M. Neonatal multidrug resistant gram-negative infection: epidemiology, mechanisms of resistance, and management |
title | Neonatal multidrug resistant gram-negative infection: epidemiology,
mechanisms of resistance, and management |
title_full | Neonatal multidrug resistant gram-negative infection: epidemiology,
mechanisms of resistance, and management |
title_fullStr | Neonatal multidrug resistant gram-negative infection: epidemiology,
mechanisms of resistance, and management |
title_full_unstemmed | Neonatal multidrug resistant gram-negative infection: epidemiology,
mechanisms of resistance, and management |
title_short | Neonatal multidrug resistant gram-negative infection: epidemiology,
mechanisms of resistance, and management |
title_sort | neonatal multidrug resistant gram-negative infection: epidemiology,
mechanisms of resistance, and management |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8819496/ https://www.ncbi.nlm.nih.gov/pubmed/34599280 http://dx.doi.org/10.1038/s41390-021-01745-7 |
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