title: Gastrointestinal colonization with ESBL-producing Klebsiella in preterm babies--is vancomycin to blame?
abstract: In this study, we examine the possible association between treatment with vancomycin and colonization with extended-spectrum beta-lactamase (ESBL)-producing Klebsiella in our neonatal intensive care unit (NICU). Variables compared between newborns which developed rectal colonization and those who did not include: gestational age, birth weight, gender, and total length of hospital stay until positive stool culture or discharge, treatment with vancomycin, and positive blood culture for coagulase-negative Staphylococcus. We found that lower birth weight, younger gestational age, and treatment with vancomycin were statistically significant risk factors for gastrointestinal colonization with ESBL-producing Klebsiella. When applying a multivariate model, treatment with vancomycin, both for a full 10-day course and for a short 3-day empirical treatment, remained statistically significant. Treatment with vancomycin is a risk factor for gastrointestinal colonization with ESBL-producing Klebsiella in premature babies.
authors.affiliation: Department of Neonatology, Hadassah and Hebrew University Medical Center, Mount Scopus, P.O. Box 24035, Jerusalem, 91240, Israel. noaofek@hadassah.org.il
authors.forename: N
authors.initials: N
authors.lastname: Ofek-Shlomai
authors.forename: S
authors.initials: S
authors.lastname: Benenson
authors.forename: Z
authors.initials: Z
authors.lastname: Ergaz
authors.forename: O
authors.initials: O
authors.lastname: Peleg
authors.forename: R
authors.initials: R
authors.lastname: Braunstein
authors.forename: B
authors.initials: B
authors.lastname: Bar-Oz
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D041981:Gastrointestinal Tract / Q000382:microbiology*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007709:Klebsiella / Q000201:enzymology* / Q000302:isolation & purification; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D047928:Premature Birth; D012307:Risk Factors; D014640:Vancomycin / Q000627:therapeutic use*; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D001618:beta-Lactamases