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Prevalence study of antimicrobial resistant organisms in very preterm neonates

Elaine Houlihan1, Anna McCormick2, Carol O ' Connor2

  • 1Department of Clinical Microbiology, National Maternity Hospital, Holles Street, Dublin, D02YH21, Ireland. e.houlihan.kenny@gmail.com.

Irish Journal of Medical Science
|February 26, 2025
PubMed

Insights

Very preterm infants in NICUs frequently carry antibiotic-resistant organisms, particularly AmpC producers. This highlights the need for enhanced infection control and screening for multi-drug resistant organisms in neonatal critical care settings.

Area of Science:

  • Neonatal Intensive Care
  • Infectious Diseases
  • Microbiology

Background:

  • Preterm neonates (<32 weeks gestation) are vulnerable to infections due to immature organ systems, skin barrier, and immune function.
  • Healthcare-associated infections (HAIs) risk is elevated in NICU settings due to factors like antibiotic exposure and invasive monitoring.
  • This study aimed to determine the prevalence of antimicrobial-resistant organism carriage in very preterm neonates.

Purpose of the Study:

  • To investigate the prevalence of antimicrobial-resistant organism carriage in very preterm neonates admitted to the Neonatal Intensive Care Unit (NICU).
  • To identify specific types of resistant organisms colonizing this vulnerable population.
  • To inform infection prevention and control strategies in neonatal critical care.

Main Methods:

  • A cohort of neonates born ≤32 weeks gestation was screened from September 2022 to January 2023.
  • Swabs were collected at admission and bi-weekly until 10 weeks of life.
  • Screening included Extended Spectrum Beta-Lactamases (ESBL), AmpC producers, gentamicin/ciprofloxacin resistance, Carbapenemase-producing Enterobacterales (CPE), Methicillin-resistant Staphylococcus aureus (MRSA), and Vancomycin-resistant Enterococci (VRE).

Main Results:

  • 38% (20/53) of neonates carried at least one resistant gram-negative organism.
  • Prevalence included 9% ESBL, 4% gentamicin-resistant, 11% ciprofloxacin-resistant, and 26% AmpC producers.
  • Resistance rates peaked at week 4; no CPE, MRSA, or VRE were detected.

Conclusions:

  • A significant proportion of very preterm infants in the NICU carry antibiotic-resistant organisms.
  • Findings underscore the importance of robust infection prevention, control, and antimicrobial stewardship.
  • Regular screening for multi-drug resistant organisms (MDROs) is recommended in neonatal critical care settings.
Abstract

Keywords:
Infection prevention and controlMulti-drug resistant organismsNeonatal sepsisPrematurityScreening

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