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Risk for secondary infections increases for rare pathogen-specific neonatal BSI
Secondary bloodstream infections caused by Pseudomonas aeruginosa and Serratia spp. were more common among very preterm infants when another infant in the same neonatal ICU was infected with the same pathogen, according to recent research in Pediatrics.
“Nosocomial infections in NICUs tend to cluster, sometimes as devastating outbreaks, but pathogen-specific transmission probabilities are unknown,” Felix Reichert, MD, of the department of neonatology at Charité University Medical Center in Germany, and colleagues wrote. “We aimed to quantify the pathogen-specific risk of a bloodstream infection (BSI) in preterm infants after an index case with that pathogen in the same department.”
The researchers used the German NICU surveillance system (2000-2011) to collect data from 44,818 neonates with a birth weight less than 1,500 g. Patient data was used to calculate the probability of BSIs when another infant in the same unit contracted an infection from the same pathogen. Infection rates during pathogen presence were compared with infection rates without similar pathogens present to determine the risk.
Study results showed that the RR of secondary BSI was significantly greater for P. aeruginosa (RR = 64.52; 95% CI, 25.69-162.05) and Serratia spp. (RR = 77.46; 95% CI, 41.08-146.09).
Results also showed that the RR for other pathogens — including Enterococcus spp., Enterobacter spp., Escherichia coli, Candida albicans, Staphylococcus aureus and Klebsiella spp. — were similar to the risk for BSIs in the absence of these pathogens.
“P. aeruginosa and Serratia spp. are exceptional in their potential to spread in the NICU and attack very low birth weight infants,” Reichert and colleagues wrote. “Because they are also those pathogens with the highest reported BSI-related mortality rates, vigorous attempts should be made to intensify infection control measures whenever P. aeruginosa or Serratia spp. have been isolated from a patient in the NICU.” – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
