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Eberhart, M; Grisold, A; Lavorato, M; Resch, E; Trobisch, A; Resch, B.
Extended-spectrum beta-lactamase (ESBL) producing Enterobacterales in stool surveillance cultures of preterm infants are no risk factor for necrotizing enterocolitis: a retrospective case-control study over 12 years.
Infection. 2020; 48(6):853-860 Doi: 10.1007/s15010-020-01453-0 [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz
Resch Bernhard
Co-Autor*innen der Med Uni Graz
Grisold Andrea
Resch Elisabeth
Trobisch Andreas

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PURPOSE: Microbial dysbiosis has been found preceding necrotizing enterocolitis (NEC) in preterm infants; thus, we aimed to investigate whether there is evidence that neonates with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) positive stool cultures are at higher risk for NEC at the NICU. METHODS: We included very preterm inborn infants of ≤ 32 weeks of gestational age being fecal carriers of ESBL-E and compared them with 1:1 matched (gestational age, birth weight, gender and year) controls tested negative for ESBL-E in the stool between 2005 and 2016. An association with NEC was defined as the first detection of ESBL-E before or at the time of definite diagnosis of NEC. RESULTS: During the study period, we diagnosed 217 infants with a total of 270 ESBL-E. We identified ten different species with ESBL-producing Klebsiella oxytoca being the most common one (46%) followed by Klebsiella pneumoniae (19%), and Citrobacter freundii (17%). Ten out of 217 infants had any kind of NEC in the case group compared to two of the controls (p < 0.01), but only four cases with predefined criteria were associated with NEC ≥ stage IIa (1.8 vs. 0.5%, p = 0.089, OR 4.1, CI95% 0.45-36.6). NEC mortality rate was 2/8 (25%). CONCLUSIONS: We observed a threefold increase of ESBL-E in stool surveillance cultures during study time and germs were dominated by ESBL-producing Klebsiella spp. There was no evidence that preterm infants colonized with ESBL-E in the stool were at higher risk for definite NEC.
Find related publications in this database (using NLM MeSH Indexing)
Austria - epidemiology
Case-Control Studies - administration & dosage
Enterobacteriaceae - isolation & purification, metabolism
Enterobacteriaceae Infections - epidemiology, microbiology
Enterocolitis, Necrotizing - epidemiology, microbiology
Feces - microbiology
Female - administration & dosage
Humans - administration & dosage
Incidence - administration & dosage
Infant, Newborn - administration & dosage
Infant, Premature - administration & dosage
Intensive Care Units, Neonatal - administration & dosage
Male - administration & dosage
Retrospective Studies - administration & dosage
Risk Factors - administration & dosage
beta-Lactamases - analysis

Find related publications in this database (Keywords)
Necrotizing enterocolitis
Preterm infant
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