October 2, 2013
Antimicrobial Therapies Linked To Neonatal Infection Outbreaks
Administration of antibiotics may have caused successive outbreaks of vancomycin-resistant enterococci (VRE) in a Greek neonatal intensive care unit (NICU), according to a study in the October issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).
A team of physicians at the Aristotle University School of Medicine in Greece responded to two occurrences of VRE in their 44-bed NICU with a bundled intervention of active surveillance, enhanced infection control measures, optimization of antimicrobial usage, and investigation of potential risk factors for VRE colonization over a six-month period. Out of 253 newborns screened, 39.9 percent were found to be carriers of VRE. During the first wave of this outbreak a single clone predominated.Antimicrobial usage, particularly administration of vancomycin and other glycopeptide antibiotics, was reduced significantly until the outbreak appeared to be over. Just as antimicrobial usage returned to previous levels, a new case of VRE was discovered and a second wave of the outbreak began.
Analysis of the data revealed antimicrobial treatment for late-onset neonatal sepsis and hospitalization during the outbreak as significant risk factors for VRE.
The authors conclude, "Both a high prevalence of VRE colonization and antimicrobial use promoted the transmission of VRE during this biphasic outbreak. Adherence to infection control measures and antimicrobial stewardship policies are of utmost importance."
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