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Updated: Jul 11, 2026
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Non-Invasive Model of Neuropathogenic Escherichia coli Infection in the Neonatal Rat
Published on: October 29, 2014
Colonization with antibiotic-resistant Gram-negative bacilli in the neonatal intensive care unit
1Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, School of Medicine, Cleveland, OH 44106, USA. pxt2@po.cwru.edu
Minerva Pediatrica
|November 11, 2003
Summary
Gram-negative bacterial infections are increasing in neonatal intensive care units (NICUs). Antibiotic resistance in these infections may be linked to prophylaxis programs and specific antibiotic use in critically ill newborns.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Microbiology
Background:
- Gram-negative bacilli infections pose a significant threat to critically ill newborns in neonatal intensive care units (NICUs).
- Recent trends indicate an increase in both the incidence and antibiotic resistance of Gram-negative bacillary infections in this vulnerable population.
- Colonization of the gastrointestinal tract and nasopharynx is a critical initial step in the development of these infections.
Purpose of the Study:
- To review the acquisition of Gram-negative bacteria, focusing on antibiotic resistance, within the NICU environment.
- To explore potential factors contributing to the rise of Gram-negative infections and resistance in newborns.
- To examine the relationship between antibiotic exposure and the emergence of resistant Gram-negative bacilli.
Main Methods:
- Review of existing data and literature on Gram-negative bacterial infections in NICUs.
- Analysis of trends in infection incidence and antibiotic resistance over the past five years.
- Examination of bacterial colonization patterns in hospitalized infants.
Main Results:
- Intrapartum antibiotic prophylaxis programs may be associated with increased early-onset Gram-negative infections and resistance.
- Late-onset, nosocomially-acquired Gram-negative infections are also on the rise in critically ill newborns.
- While some cross-transmission of resistant bacteria occurs, most colonizing resistant strains are infant-specific.
- Aminoglycoside use shows less association with resistance emergence compared to higher-generation cephalosporins.
Conclusions:
- The ecology of the NICU includes antibiotic-resistant Gram-negative bacilli, acquired similarly to susceptible strains.
- Higher-generation cephalosporins may accelerate the emergence of beta-lactam-resistant bacilli in newborns.
- Further research is needed to precisely quantify the impact of antibiotic exposure on resistance acquisition in the NICU.
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