Bacterial colonization of neonates admitted to an intensive care environment

https://doi.org/10.1016/S0022-3476(78)80523-XGet rights and content

In order to elucidate some of the factors responsible for the high rate of nosocomial infection associated with neonatal intensive care, we studied bacterial colonization in 63 infants admitted to a neonatal intensive care unit. In a six-month period, cultures of nose, throat, umbilicus, and stool were obtained on admission and every three days from all infants staying in the NICU≥3 days. Study infants did not develop “normal” aerobic flora. Forty-eight percent of infants grew Escherichia coli from stool, but 52% had stool colonization with Klebsiella, Enterobacter, or Citrobacter, the only other Enterobacteriaceae encountered. KEC were also isolated from throat, nose, and umbilicus in 22%, 22%, and 24% of patients, respectively. The risk of stool colonization with KEC increased with duration of hospitalization: 2% of infants were colonized on admission, 60% after 15 days, and 91% after 30 days. Stool colonization with E. coli seemed to protect infants from colonization with other gram-negative bacilli. Thirteen of 20 infants, however, developed pharyngeal GNB colonization in spite of pre-existing abundant growth of alpha streptococci. Antibiotic therapy for >3 days was associated with the isolation of KEC in stool and GNB in the throat, but birth weight <2,500 gm and lack of breast milk feedings were not.

References (37)

  • KaslowRA et al.

    Staphylococcal disease related to hospital nursery bathing practices—a nationwide epidemiologic investigation

    Pediatrics

    (1973)
  • KleinJO et al.

    Bacterial infections

  • EisenachKD et al.

    Nosocomial infections due to kanamycin-resistant, (R)-factor carrying enteric organisms in an intensive care nursery

    Pediatrics

    (1972)
  • BalagtasRC et al.

    Risk of local and systemic infections associated with umbilical vein catheterization: A prospective study in 86 newborn patients

    Pediatrics

    (1971)
  • GoldmannDA et al.

    Infection control in total parenteral nutrition

    JAMA

    (1973)
  • PierceAK et al.

    Bacterial contamination of aerosols

    Arch Intern Med

    (1973)
  • WeinsteinRA et al.

    Pressure monitoring devices: Overlooked sources of nosocomial infection

    JAMA

    (1976)
  • BurkeJP et al.

    Proteus mirabilis infections in a hospital traced to a human carrier

    N Engl J Med

    (1971)
  • Cited by (230)

    • Serratia marcescens outbreak in a neonatology unit of a Spanish tertiary hospital: Risk factors and control measures

      2019, American Journal of Infection Control
      Citation Excerpt :

      Prematurity is a previously known risk factor that has been implicated in several outbreaks.14,18,22 This risk may be related to the incompletely established intestinal microbiota, making preterm infants more susceptible to colonization by microorganisms present in health care facilities.23 Preterm infants are also more susceptible to infection, owing to an immature immune system and less effective skin and mucosal barriers,5 which may be weakened as a consequence of invasive procedures that are performed more frequently in preterm infants admitted to NICUs.

    • Clinical Significance of Bifidobacteria

      2017, The Bifidobacteria and Related Organisms: Biology, Taxonomy, Applications
    View all citing articles on Scopus
    1

    From the Department of Medicine, the Division of Infectious Diseases, and the Bacteriology Laboratory, Children's Hospital Medical Center; and the Department of Pediatrics, Harvard Medical School.

    View full text