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Published on: February 9, 2011
Risk factors of multidrug-resistant organisms neonatal sepsis in Surabaya tertiary referral hospital: a single-center
Stefani Miranda1, Aminuddin Harahap2, Dominicus Husada3
1Department of Child Health, Faculty of Medicine, Hang Tuah University/dr. Ramelan Navy Central Hospital, Jalan Gadung No. 1, Surabaya, East Java, 60244, Indonesia. stefmir10@gmail.com.
Background:
Bacterial organisms causing neonatal sepsis have developed increased resistance to commonly used antibiotics. Antimicrobial resistance is a major global health problem. The spread of Multidrug-Resistant Organisms (MDROs) is associated with higher morbidity and mortality rates. This study aimed to determine the risk factors for developing MDRO neonatal sepsis in the Neonatal Intensive Care Unit (NICU), dr. Ramelan Navy Central Hospital, in 2020-2022.
Methods:
A cross-sectional study was performed on 113 eligible neonates. Patients whose blood cultures were positive for bacterial growth and diagnosed with sepsis were selected as the study sample. Univariate and multivariate analysis with multiple logistic regression were performed to find the associated risk factors for developing multidrug-resistant organism neonatal sepsis. A p-value of < 0.05 was considered significant.
Results:
Multidrug-resistant organisms were the predominant aetiology of neonatal sepsis (91/113, 80.5%). The significant risk factors for developing MDRO neonatal sepsis were lower birth weight (OR: 1.607, 95% CI: 1.003 - 2.576, p-value: 0.049), history of premature rupture of the membrane (ProM) ≥ 18 (OR: 3.333, 95% CI: 2.047 - 5.428, p-value < 0.001), meconium-stained amniotic fluid (OR: 2.37, 95% CI: 1.512 - 3.717, p-value < 0.001), longer hospital stays (OR: 5.067, 95% CI: 2.912 - 8.815, p-value < 0.001), lower Apgar scores (OR: 2.25, 95% CI: 1.442 - 3.512, p-value < 0.001), and the use of respiratory support devices, such as invasive ventilation (OR: 2.687, 95% CI: 1.514 - 4.771, p-value < 0.001), and non-invasive ventilation (OR: 2, 95% CI: 1.097 - 3.645, p-value: 0.024).
Conclusions:
Our study determined various risk factors for multidrug-resistance organism neonatal sepsis and underscored the need to improve infection control practices to reduce the existing burden of drug-resistant sepsis. Low-birth-weight, a maternal history of premature rupture of the membrane lasting more than 18 hours, meconium-stained amniotic fluid, longer hospital stays, a low Apgar score, and the use of ventilators were the risk factors for developing drug-resistant neonatal sepsis.
Insights
Multidrug-resistant organism neonatal sepsis is a significant threat, with risk factors including low birth weight, prolonged membrane rupture, and meconium-stained fluid. Improving infection control is crucial to combat drug-resistant infections in newborns.
Area of Science:
- Neonatal Intensive Care Unit (NICU) research
- Infectious Diseases
- Public Health
Background:
- Antimicrobial resistance is a growing global health crisis, particularly concerning in neonatal sepsis.
- Multidrug-Resistant Organisms (MDROs) contribute to increased morbidity and mortality in neonates.
- Understanding risk factors for MDRO neonatal sepsis is critical for effective intervention.
Purpose of the Study:
- To identify significant risk factors associated with the development of Multidrug-Resistant Organism (MDRO) neonatal sepsis.
- To inform targeted infection control strategies within the Neonatal Intensive Care Unit (NICU).
Main Methods:
- A cross-sectional study involving 113 neonates diagnosed with sepsis.
- Blood cultures were analyzed for bacterial growth.
- Univariate and multivariate logistic regression analyses were employed to determine risk factors.
Main Results:
- Multidrug-resistant organisms (MDROs) were identified in 80.5% of neonatal sepsis cases.
- Significant risk factors included lower birth weight, premature rupture of membranes (≥18 hours), and meconium-stained amniotic fluid.
- Longer hospital stays, lower Apgar scores, and respiratory support (invasive/non-invasive ventilation) were also significant risk factors.
Conclusions:
- Several key factors increase the risk of developing drug-resistant neonatal sepsis.
- The findings highlight the urgent need for enhanced infection control measures in NICUs.
- Addressing these risk factors can help mitigate the burden of antibiotic resistance in neonatal care.
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