Abstract
Background: Microbial antibiotic resistance is a major public health concern. The bowel flora of babies nursed on neonatal units is characterised by few normal commensals and may be dominated by hospital acquired organisms. In a pilot study 18 of 22 (82%) babies who had been on NICU >7days were found to have stools colonised with antibiotic resistant Gram negative bacilli (rGNB) at times between discharge and 357days. The objective of the present study was to investigate the rate and clinical associates of colonisation with rGNB in a population of VLBW babies on a second neonatal unit.
Methods: Babies <1500g birthweight and >23 weeks gestational age were recruited into a study involving randomisation to receive Bifidobacterium breve BBG for 28 days starting within 48h of birth. Quantitative microbiological analysis was performed on the available stool closest to 28 days.
Results: 40 babies (median BWt 864g, IQR 777–1144g; GA 26.8w, IQR 25.4–29.0w) were recruited of whom 38 survived to 28d. Stools were available for 34 of these. 25(74%) were colonised with GNB resistant to one class of antibiotics and 10(29%) had multi-resistant strains. Of 16 babies born to women on antibiotics at the time of delivery, 8 (50%) were colonised with multi-resistant GNB (mrGNB) compared with only 2 of 18(11%) babies whose mothers were not on antibiotics, p=0.023. There were no other statistically significant associations between gestational age, birthweight, birhweight Z-score, sex, prolonged membrane rupture, antenatal steroids, caesarian section, whether or not the baby was colonised with Bifidebacterium breve BBG at 28d, the number of days the baby was on antibiotics or whether the baby had received a cephalosporin in the first 28d and colonisation with either rGNB or mrGNB.
Conclusion: Rates of intestinal colonisation of babies cared for on our NICUs with antibiotic resistant Gram negative bacilli appear to be high and posibly to be associated with the use of maternal antibiotics around the time of birth. Further work is needed to explore this phenomenon further and to determine whether the graduates of our nurseries represent a public health risk in the community following discharge.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Philpott, A., Jesudass, R., Al Nakib, L. et al. 214 Intestinal Colonisation of Very Low Birth Weight Infants with Antibiotic Resistant Gram Negative Bacilli. Pediatr Res 56, 500 (2004). https://doi.org/10.1203/00006450-200409000-00237
Issue Date:
DOI: https://doi.org/10.1203/00006450-200409000-00237