A study on risk factors of intestinal bacteria colonization and antibiotic resistance in NICU neonates / 中国新生儿科杂志

ABSTRACT

Objective To study the risk factors of intestinal bacteria colonization and antibiotic resistance among newborns in neonatal intensive care unit (NICU).Method From May 2014 to May 2015,newborns admitted to NICU in our hospital were enrolled and their feces were prospectively collected and cultured from day 5 to day 7 after birth.VITEK-2 system was used to identify the bacteria and determine their antibiotic susceptibility.Newborns were assigned into 8 groups according to their gestational age,mode of delivery and use of antibiotics,and the colonization rates of Escherichia coli (E.coli),Enterococcus and Klebsiella pneumoniae were compared.Result A total of 572 feces of newborns were collected,328 strains of E.coli,243 strains of Enterococcus and 70 strains of Klebsiella pneumoniae were isolated.The multi-drug resistance rates of E.coli and Enterococcus were 68.3％ (136/199) and 76.1％ (185/243),respectively.The colonization rates of E.coli,Enterococcus and Klebsiella pneumoniae of the full-term delivery without antibiotics group (77 cases),full-term Cesarean section (C-section) without antibiotics group (30 cases),premature C-section without antibiotics group (28 cases),premature delivery without antibiotics group (16 cases),premature delivery with antibiotics group (53 cases),full-term delivery with antibiotics group (155 cases),full-term C-section with antibiotics group (99 cases),premature C-section with antibiotics group (114 cases) were different.The antibiotics groups showed significantly less E.coli colonization rates and higher Enterococcus colonization rates than the non-antibiotics groups of the same gestational age and delivery mode (P ＜ 0.05).The result between the full-term C-section newborns and naturally delivered newborns without antibiotics indicated the similar trend (P ＜ 0.05).The colonization rates of Klebsiella pneumoniae showed no significant differences among the groups (P ＞ 0.05).Conclusion The multi-drug resistance of E.coli and Enterococcus in neonatal intestinal colonization is common and worrisome.Bacterial colonization is affected by antibiotics and the mode of delivery and prudent use of antibiotics is advised.