High Burden of Bloodstream Infections Associated with Antimicrobial Resistance and Mortality in the Neonatal Intensive Care Unit in Pune, India.

摘要: BACKGROUND Antimicrobial resistance (AMR) is a growing threat to newborns in low and middle income countries (LMIC). METHODS We performed prospective cohort study three tertiary Neonatal Intensive Care Units (NICUs) Pune, India, describe the epidemiology of neonatal bloodstream infections (BSI). All neonates admitted NICU were enrolled. The primary outcome was BSI, defined as positive blood culture. Early onset BSI on day life (DOL) 0-2 late DOL 3 or later. RESULTS From May 1, 2017, until April 30, 2018, 4073 Among at risk neonates, 55 (1.6%) developed early 176 (5.5%) BSI. majority caused by Gram-negative bacteria (GNB) (58%); among GNB, 61 (45%) resistant carbapenems. Klebsiella spp. (n=53, 23%) most common cause Compared with without all-cause mortality higher (31% vs. 10%, p<0.001) (24% 7%, p<0.001). Non-low birth weight had greatest excess mortality, (22% 3%, CONCLUSIONS In our cohort, commonly high prevalence AMR, associated even term neonates. Effective interventions are urgently needed reduce burden death due AMR GNB hospitalized LMIC.