What Happens When Baby Gets Infected With E Coli at Birth

• Research article
• Open Access
• Published: eighteen October 2014

Mode of delivery and other risk factors for Escherichia coli infections in very depression birth weight infants

• Jadwiga Wójkowska-Mach^ane,
• Dorota Romaniszyn¹,
• Paweł Adamski²,
• Ewa Helwich^three,
• Ryszard Lauterbach^iv,
• Monika Pobiega¹,
• Maria Borszewska-Kornacka⁵,
• Ewa Gulczyńska⁶,
• Agnieszka Kordek^vii &
• Piotr B Heczko^ane

BMC Pediatrics volume fourteen, Article number:274 (2014) Cite this article

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Abstruse

Background

Infections in newborns remain one of the most meaning problems in modern medicine. Escherichia coli is an important cause of neonatal bloodstream and respiratory tract infections and is associated with high mortality. The aim of our study was to investigate the epidemiology of Due east. coli infection in Polish neonatal intensive intendance units (NICUs) and resistance to antibiotics, with detail reference to the safety of very depression nativity weight infants.

Methods

Continuous prospective infection surveillance was conducted in 2009–2012 in five NICUs, including one,768 newborns whose birth weight was <1.5 kg. Escherichia coli isolates from different diagnostic specimens including blood, tracheal/bronchial secretions and others were nerveless. All isolates were tested using disk diffusion antimicrobial susceptibility methods. Pulsed-field gel electrophoresis was used to determine the possible horizontal transfer of E. coli among patients.

Results

The incidence of Eastward. coli infections was five.4% and 2.0/one,000 patient-days. The occurrence of E. coli infections depended significantly on the NICU and varied betwixt 3.9% and 17.nine%. Multivariate analysis that took into account the combined effect of demographic data (gender, gestational historic period and birth weight) and place of nativity showed that only the identify of hospitalisation had a significant effect on the Due east. coli infection take a chance. The highest levels of resistance among all E. coli isolates were observed against ampicillin (88.eight%) and amoxicillin/clavulanic acrid (62.ii%). Among E. coli isolates, 17.vii% were classified as multidrug resistant. Escherichia coli isolates showed dissimilar pulsotypes and dominant epidemic clones were non detected.

Conclusions

Our information indicate that antibody prophylaxis in the presence of symptoms such as chorioamnionitis and premature rupture of membranes did not help reduce the adventure of E. coli infection. Multivariate analysis demonstrated only one pregnant risk factor for E. coli infection among infants with a birth weight <1.5 kg, that is, the impact of the NICU, it means that both neonatal intendance and care during pregnancy and labour were found to be significant.

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Background

Infections in newborns, specially those with very depression birth weight of <1.5 kg, remain one of the near significant bug in modernistic medicine. Escherichia coli is an important crusade of neonatal bloodstream and respiratory tract infections and is associated with high mortality [1, 2].

In tardily-onset infection, E. coli may be acquired from the mother or the environment and may enter the bloodstream from the urinary or gastrointestinal tract [three]. Several studies have demonstrated a high rate of transmission of E. coli within families and households [4, v]. Escherichia coli species incorporate commensal strains, abdominal pathogenic strains and others that cause infections outside the gastrointestinal system, such every bit extra-intestinal pathogenic E. coli. Extra-intestinal infections due to E. coli are mutual in all historic period groups and include bacteremia, urinary tract infection, meningitis (mostly in neonates), nosocomial pneumonia and others [6].

Cephalosporin, fluoroquinolone and trimethoprim-sulfamethoxazole are widely used to treat infections caused by East. coli and resistance to these agents is responsible for treatment failure [seven]. The development of multidrug resistance (MDR) among Due east. coli isolates is besides of business organisation [8].

Enterobacteriaceae-producing extended-spectrum β-lactamases (ESBLs) have emerged as serious pathogens in hospitals and have been increasingly implicated in nosocomial outbreaks in neonatal intensive care units (NICUs). They take important therapeutic implications equally they exhibit resistance to several antimicrobial agents, including 3rd-generation cephalosporins, extended-spectrum penicillin and monobactam. Carbapenems and cephamycins stand for the but classes of antibiotics active confronting ESBLs [nine].

Escherichia coli has been reported as ane of the major causes of neonatal infections that may cause high morbidity and mortality [10]. Potential risk factors of E. coli neonatal infections have besides been analysed.

Considering the increasing antimicrobial resistance and mortality in NICUs, at that place is an urgent demand to understand the epidemiology and risk factors of Eastward. coli infections. Therefore, the aim of our report was to investigate the epidemiology of infections caused by E. coli in v Polish NICUs, resistance to antibiotics and potential run a risk factors that may contribute to such infections (E. coli infections were compared with infections caused past other bacteria). We likewise considered the possibility of using data on E. coli infection in assessing the quality of perinatal intendance. All these information may contribute to infection prevention and better control, and the routes of manual of E. coli were also evaluated.

Methods

Ethics

The Polish Neonatal Surveillance Network (PNSN), whose managing director is Prof. Ewa Helwich from the Institute of Mother and Child in Warsaw, covered six Neonatal Clinics within the territory of Poland: Clinic of Neonatology and Intensive Neonatal Care, Found of Mother and Kid, Warsaw, Clinic of Neonatology, Jagiellonian University Medical College, Krakow, Clinic of Neonatology and Intensive Neonatal Care, Warsaw Medical University, Warsaw, Clinic of Neonatology, Shine Mothers' Memorial Hospital-Research Institute, Lodz, Department of Neonatal Diseases, Pomeranian Medical University, Szczecin and Gynaecology and Obstetrics Hospital Medical Academy Poznan. The Polish Neonatal Surveillance Network was established on 6th of September 2007 (Agreement; see zipper). The Chair of Microbiology cooperated within the program of the PNSN. Utilization of information nerveless in the PNSN for scientific purposes was canonical by the Bioethics Committee of Jagiellonian University Medical Higher (Chairperson Prof. Piotr Thor) – no. KBET/221/B/2011 ) on 27 October 2011 (Appropoval; encounter attachement). All data entered into the electronic database and analysed during this written report were previously anonymised and de-identified.

Report population

A prospective surveillance of infections was conducted betwixt 1 January 2009 and 31 December 2012 in five from half dozen NICUs that participated in the activities of the PNSN.

The study covered 1,768 newborns. All episodes of infection were subjected to registration, regardless of the fourth dimension of occurrence of the first symptoms. Case patients were defined according to Gastmeier et al. [11], with modifications for neonates with birth weight <1.5 kg. Early on-onset infection (EOI) was defined equally infection diagnosed within three days of delivery. The occurrence of chorioamnionitis was based on clinical data (all cases) and histopathology examination of the placenta (~65% of cases).

Bacterial isolates

Various diagnostic specimens including blood, and tracheal/bronchial secretions were collected for culture and assessment of the microbial aetiology of infections. Altogether, 96 E. coli strains were isolated, and the present report covered ninety isolates (half dozen were not stored). Isolates were identified past the automated identification system (VITEK ii; bioMérieux, Warsaw, Poland). Isolates from other infections were also analysed. Aetiological factors of other infections were: other Gram-negative bacteria, Gram-positive bacteria, atypical leaner and yeast.

Antimicrobial susceptibility

All isolates were tested using deejay diffusion antimicrobial susceptibility methods on Mueller–Hinton agar plates according to the current EUCAST guidelines (European Committee on Antimicrobial Susceptibility Testing. Clinical breakpoint tables v. iii.1; http://www.eucast.org five.3.one, accessed: 11.02.2013). ESBL action was detected with a modified double disk synergy test using a combination of cefotaxime, ceftazidime, cefepime and aztreonam discs, placed 20 mm apart around the disc containing amoxicillin/clavulanic acid [12].

Pulsed-field gel electrophoresis (PFGE)

PFGE was used to make up one's mind the possible horizontal transfer of East. coli strains among patients. All isolates were analysed using the standardized PFGE protocol developed at the Centers for Affliction Control and Prevention past the PulseNet program http://ttp://www.cdc.gov/pulsenet/pathogens/ecoli.html (accessed: eleven.02.2013). Genomic Dna was digested with 10 U XbaI (ThermoScientific, ABO, Gdansk, Poland). The resulting Dna fingerprinting was analysed using the CHEF Iii PFGE arrangement (BioRad, Warsaw, Poland) in 0.5 Tris–borate–EDTA buffer at 14°C at half-dozen V for 20 h with a ramped pulse time of 2.two–54.2 due south. The GelCompar (Applied Maths) was used for cluster analysis using the Die coefficient and the unweighted pair group method with arithmetic hateful.

Hazard factors

Several potential take a chance factors were compared co-ordinate to infections acquired by E. coli and by other strains: nascency weight, gestational age, CRIB, Apgar score, sex, type of nativity, feeding patterns (breastfeeding, trophic feeding, or parenteral diet), perinatal antibiotic prophylaxis, prolonged premature rupture of membranes (PROM).

Statistical analysis

The influence of blazon of care and sociodemographic characteristics on the epidemiology of East. coli/other infection was analysed with several statistical techniques, depending on type and distribution of analysed variables. The relation between probability of E. coli and continuous parameters (historic period, length of stay) was based on simple analysis of variance (ANOVA). If the distribution of continuous variables significantly differed from normality, the nonparametric culling to ANOVA, the Kruskal–Wallis test, was used. For the contingency of nominal characters frequency test: Pearson's chi-foursquare (χⁱⁱ) and likelihood ratio was used. The common influence of take chances factors on Eastward. coli identification was analysed with a generalised linear model. Considering of the categorical character of the effect and combined — numerical as well as categorical — types of the predictors, the model was constructed for binominal distribution of dependent variables and logit-linked part. A p value <0.05 was considered significant. All analyses were performed using JMP version 9.iii (SAS Institute Inc., Cary, NC, USA).

Results

Non-E. coliinfections

Neonates with infections of non-Eastward. coli aetiology were characterised by ameliorate general condition at nascency (Table 1) than neonates with E. coli infections. Significantly fewer infants had adverse perinatal outcomes, such as PROM or chorioamnionitis, while significantly more newborns were delivered by caesarean section. The fatality rate of newborns with non-E. coli infections was two times lower than in those with Eastward. coli infections.

Table 1 The characteristics of newborns with symptoms of infections and E. coli infections

Full size table

Escherichia coliinfections

The incidence of E. coli infections was 5.4% and ii.0/1,000 patient-days. EOIs accounted for 12.2% of all infections and late-onset infections (LOIs) accounted for 10.v%. The incidence of EOIs was one.7% and LOIs was three.7%. The occurrence of East. coli infections (both EOI and LOI) depended significantly on the NICU (χ^two = 73,836; p < 0.0001) and varied between 3.nine% and 17.9%. The well-nigh common East. coli infection was pneumonia (53.i%) and bloodstream infection (forty.six%). Escherichia coli infections were diagnosed at twenty-four hour period 17 on boilerplate (median: 12 days).

The mean length of hospitalisation (from nascence to discharge, or until a weight of one.8 kg was reached) of newborns with non-Eastward. coli infections was significantly shorter: 48 versus 55 days (infants with E. coli infection).

The gestational age and birth weight of newborns with E. coli infections were lower than in those without infection or with other infections (Tabular array 1). The other hazard factors of E. coli infections were: low Apgar ane and Apgar 5 scores, total parenteral nutrition, chorioamnionitis, or PROM diagnosed during pregnancy or delivery (Tabular array 1).

Caesarean department reduced the risk of E. coli infection, although perinatal antibiotic prophylaxis (PAP) (no standardised protocol) did not reduce the risk of infection; that is, despite the use of PAP, E. coli infections were observed significantly more oftentimes (Table 1).

Multivariate analysis

Multivariate assay that took into account the combined issue of intrapartum antibiotic prophylaxis (IAP), PROM, chorioamnionitis and delivery way (caesarean section) showed no significant result on the gamble of East. coli infection for factors other than the mode of delivery. However, multivariate analysis that took into business relationship the combined result of demographic data (sex, gestational historic period and nativity weight) and place of birth (NICU) showed that simply the place of hospitalisation had a significant effect on Due east. coli infection chance.

Finally, a multivariate analysis of maternal influences on IAP, PROM, amniotic inflammation, type of labour, gestational age, NICU and the likelihood of specific Due east.coli infections (vs. other infections) showed a significant statistical relationship with the complete model.

Escherichia coli resistance and similarity of strains

Analysis of the isolates showed that the highest levels of resistance among all E. coli isolates were observed against ampicillin (88.viii%) and amoxicillin/clavulanic acid (62.two%), trimethoprim/sulfamethoxazole (34.4%) and aztreonam (33.3%). The ESBL phenotype was found among 25 isolates (27.seven%). Sixteen of the ESBL-positive strains (17.7%) were besides reported as resistant to at least 2 other groups of antibiotics (fluoroquinolones, aminoglycosides or trimethoprim–sulfamethoxazole), which allows us to consider these strains as MDR organisms (Table ii).

Table two Characteristics of ESBL-positive strains

Full size tabular array

Resistance to ampicillin (p = 0.0375), amoxicillin/clavulanic acid, ceftazidime, cefotaxime, cefuroxime, cefepime, aztreonam (all p-values <0.0001), amikacin (p = 0.0012), gentamicin (p = 0.0016), tobramycin (p < 0.0001), trimethoprim/sulfamethoxazole (p = 0.0016) and ciprofloxacin (p < 0.0001) in a grouping of ESBL-positive strains was significantly higher than in ESBL-negative strains. Only five of the studied isolates studies were resistant to one of 4 tested carbapenems; three of these isolates vest to non-ESBL strains. Almost all E. coli strains (97.viii%) were susceptible to tigecycline and piperacillin/tazobactam.

Escherichia coli isolates showed that different pulsotypes and ascendant epidemic clones were not detected. Cluster analysis based on PFGE of the 90 isolates showed 71 unique types, some of which were <seventy% similar, suggesting a genotypically variable population (Figure 1). Isolates that take identical pulsotypes commonly were derived from the same patient (equally in the example of 11 isolates) or were isolated from different patients of the same NICU in the same period of time (in the case of seven isolates). The location of the NICU and the site of the isolation did not appear to accept a correlation in the cluster analysis.

Figure i

Results of PFGE typing of E. coli isolates.

Full size image

Discussion

Infections in newborns, especially those with very low and extremely depression birth weights of <one.five kg, are a significant problem. Escherichia coli is responsible for a smaller fraction of neonatal infections than other microorganisms, but it is associated with the highest mortality [13].

Data nerveless past the European Antimicrobial Resistance Surveillance Network confirm that in Europe from 2002 to 2009 the occurrence of Due east. coli in bloodstream infections increased by more (71%) than Staphylococcus aureus (34%), which indicates the growing importance of E. coli in the epidemiology of infections [14] and the demand for detailed molecular studies of these strains. Our study was performed to characterise the population of Due east. coli isolated from neonatal infections; mainly from pneumonia and bloodstream infections from Polish NICUs.

According to other data, East. coli causes about 9% of infections [15] or five–thirteen% of LOI in NICUs [15–17]. Additionally, in Polish NICUs, E. coli was the most frequently isolated pathogen in early-onset PNSN infections [18]. In recent years, E. coli infections in NICUs take become more prevalent, and it is believed that this is mainly owing to the implementation of PAP [xix–21].

Other studies on Eastward. coli accept identified that depression gestational age [22], duration of hospital stay [23] and utilise of antibiotics [24–26] are the risk factors of colonisation and infection among newborns. Our results support these data, and we hypothesise that some other major adventure factor may be maternal colonisation. According to Denkel et al., colonised mothers may be an important reservoir of Due east. coli and significant risk factors for E. coli colonisation, and consequently, E. coli infections of very low nascence weight infants [27].

Unfortunately, screening of mothers was non performed in NICUs of PNSN, but our PFGE results back up our hypothesis: the population of E. coli was divergent and no epidemic clones were identified. That is totally different than for other species such as methicillin-resistant S. aureus or Klebsiella pneumoniae [28].

The mode of commitment seems to be a protective factor against E. coli infections and besides supports the hypothesis on maternal–neonatal transmission. About 17.nine% of neonates without infections were born vaginally, compared with 35.4% of those with East. coli infection. The vagina is a significant reservoir of E. coli, which can be disquisitional in vertical transmission of Due east. coli infection. Our results indicate that perinatal factors and vaginal manual may also significantly touch on the epidemiology of Due east. coli infection, including LOI, which could be of import for command of hospital-acquired infections.

In our written report, the fatality rate of E. coli infections was about twice equally high equally that of infections of other aetiology. The reason for this was mainly the high pathogenicity of E. coli: the majority of tested strains belonged to one of two virulence groups (B2, 68.9%, or D, 17.8%) [six, 29]. Isolates from the B2 group had significantly more virulence genes than isolates from other groups; in detail, fimH, sfa, ireA, fhuA, fyuA and fepA genes were more than probable to occur [29]. Similarly, 36.6% of strains belonged to the ST131 clone and showed a high level of virulence and resistance, which could play an of import role in the epidemiological success of this sequence blazon. Clonal group ST131 independent slightly more than one-third of the studied isolates and had a link to ESBL production [29].

Among ESBL-positive isolates, which deemed for 27.7% of all isolates, higher levels of resistance to aminoglycosides and also ciprofloxacin and trimethoprim-sulfamethoxazole were observed compared with non-ESBL isolates. The higher level of resistance may contribute to the fact that such resistance is localised mainly on plasmids and may be hands transferred not but among E. coli isolates, simply also among isolates belonging to other species. Using of one of the antibiotics (β-lactam, aminoglycoside, or fluoroquinolones) may pb to the co-choice of fluoroquinolone resistance by β-lactams or aminoglycosides, and vice versa β-lactams or aminoglycoside resistance by fluoroquinolones [30].

Conclusions

Our report showed that at that place are some risk factors that should be considered during perinatal intendance. Routine screening of mothers and newborns for Eastward. coli should be implemented in motherhood care to decrease morbidity and bloodshed. Pre-partum hospitalisation for premature labour should be an indication for screening by rectal swabs, prenatally and on the day of nascence. Unfortunately, the presented data indicate that PAP in the presence of symptoms such as chorioamnionitis and PROM did non help to reduce the run a risk of Eastward. coli infections. Multivariate analysis demonstrated only one significant run a risk gene for Eastward. coli infection amid infants with a nativity weight <i.5 kg, namely, the impact of the NICU.

Consent

Electronic database created as the result of continuous prospective targeted surveillance of infections was used in the study.

Participation of hospitals in PNSN was voluntary and confidential. Utilization of data collected in PNSN for the scientific purpose was approved by the Bioethics Committee of Jagiellonian University Medical Higher – no. KBET/221/B/2011. All data entered into the electronic database and analyzed during preparing this article were previously anonymized and de-identified. Those data were obtained nether routine treatment and diagnostic procedures performed during patients' hospitalization. No additional samples were collected for testing. According to Polish law, utilization this kind of data for scientific purpose does non demand patients' understanding or even data that information are collected in the database.

Abbreviations

BSI:

Bloodstream infection

EOI:

Early-onset infection

ESBL:

Extended-spectrum β-lactamase

IAP:

Intrapartum antibiotic prophylaxis

LOI:

Late-onset infection

MDR:

Multidrug resistance

NICU:

Neonatal intensive care unit

PAP:

Perinatal antibiotic prophylaxis

PFGE:

Pulsed-field gel electrophoresis

PROM:

Premature rupture of membranes.

References

1. Stoll BJ, Hansen N, Higgins RD, Fanaroff AA, Duara Due south, Goldberg R, Laptook A, Walsh M, Oh W, Hale E: National institute of child wellness and man development: very depression birth weight preterm infants with early onset neonatal sepsis: the predominance of gram-negative infections continues in the national plant of child health and human evolution neonatal research network, 2002–2003. Pediatr Infect Dis J. 2005, 24: 635-639. x.1097/01.inf.0000168749.82105.64.

   Article  PubMed  Google Scholar

2. Doit C, Mariani-Kurkdjian P, Mahjoub-Messai F, Bidet P, Bonacorsi S, Ballad A, Varon E, Bingen E: Epidemiology of paediatric community-acquired bloodstream infections in a children'southward hospital in Paris, France, 2001 to 2008. Diagn Microbiol Infect Dis. 2010, 66: 332-335. 10.1016/j.diagmicrobio.2009.10.012.

   Article  PubMed  Google Scholar

3. Soto SM, Bosch J, Jimenez De Anta MT, Vila J: Comparative written report of virulence traits of Escherichia coli clinical isolates causing early and late neonatal sepsis. J Clin Microbiol. 2008, 46: 1123-1125. 10.1128/JCM.01682-07.

   CAS  Article  PubMed  Google Scholar

4. Birgy A, Mariani-Kurkdjian P, Bidet P, Doit C, Genel Due north, Courroux C, Arlet G, Bingen East: Characterization of extended-spectrum-beta-lactamase-producing Escherichia coli strains involved in maternal-fetal colonization: prevalence of Due east. coli ST131. J Clin Microbiol. 2013, 51 (6): 1727-1732. 10.1128/JCM.03255-12.

   Commodity  PubMed  PubMed Central  Google Scholar

5. Rodríguez-Baño J, López-Cerero Fifty, Navarro MD, Díaz De Alba P, Pascual A: Faecal carriage of extended-spectrum β-lactamase-producing Escherichia coli: prevalence, risk factors and molecular epidemiology. J Antimicrob Chemother. 2008, 62: 1142-1149. 10.1093/jac/dkn293.

   Article  PubMed  Google Scholar

6. Pitout JD: Extraintestinal: pathogenic Escherichia coli: a combination of virulence with antibiotic resistance. Front Microbiol. 2012, 3: ix-

   Article  PubMed  PubMed Central  Google Scholar

7. Woodford Due north, Turton JF, Livermore DM: Multiresistant Gram-negative bacteria: the office of high-risk clones in the dissemination of antibiotic resistance. FEMS Microbiol Rev. 2011, 35: 736-755. x.1111/j.1574-6976.2011.00268.x.

   CAS  Article  PubMed  Google Scholar

8. Hawkey PM, Jones AM: The changing epidemiology of resistance. J Antimicrob Chemother. 2009, 64: iii-ten. x.1093/jac/dkp256.

   Article  Google Scholar

9. Coque TM, Baquero F, County R: Increasing prevalence of ESBL-producing Enterobacteriaceae in Europe. Euro Surveill. 2008, 13: 47-

   Google Scholar

10. Stoll BJ, Hansen North, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, Lemons JA, Donovan EF, Stark AR, Tyson JE, Oh W, Bauer CR, Korones SB, Shankaran Due south, Laptook AR, Stevenson DK, Papile LA, Poole WK: Changes in pathogens causing early-onset sepsis in very-depression-birth-weight infants. N Engl J Med. 2002, 25 (4): 240-247.

    Article  Google Scholar

11. Gastmeier P, Geffers C, Schwab F, Mitzner J, Oblader M, Ruden H: Development of a surveillance organisation for nosocomial infections: the component for neonatal intensive intendance in Frg. J Hosp Infect. 2004, 57: 126-131. 10.1016/j.jhin.2003.12.038.

    CAS  Article  PubMed  Google Scholar

12. Drieux L, Brossier F, Sougakoff W, Jarlier V: Phenotypic detection of extended-spectrum β-lactamase production in Enterobacteriaceae: review and bench guide. Clin Microbiol Infect. 2008, 14: 90-103. 10.1111/j.1469-0691.2007.01846.10.

    CAS  Article  PubMed  Google Scholar

13. Stoll BJ, Hansen North, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, Lemons JA, Donovan EF, Stark AR, Tyson JE, Oh W, Bauer CR, Korones SB, Shankaran Southward, Laptook AR, Stevenson DK, Papile LA, Poole WK: Late-onset sepsis in very low nascency weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics. 2002, 110: 285-291. 10.1542/peds.110.2.285.

    Article  PubMed  Google Scholar

14. Gagliotti C, Balode A, Baquero F, Degener J, Grundmann H, Gür D, Jarlier V, Kahlmeter M, Monen J, Monnet DL, Rossolini GM, Suetens C, Weist Yard, Heuer O: EARS-Net Participants (Disease Specific Contact Points for AMR). Escherichia coli and Staphylococcus aureus: bad news and expert news from the European Antimicrobial Resistance Surveillance Network (EARS-Net, formerly EARSS), 2002 to 2009. Euro Surveill. 2011, 17: 19819-Erratum in: Euro Surveillance 2011, sixteen:19834

    Google Scholar

15. Babazono A, Kitajima H, Nishimaki South, Nakamura T, Shiga South, Hayakawa K, Tanaka T, Sato Chiliad, Nakayama H, Ibara S, Une H, Doi H: Risk factors for nosocomial infections in the neonatal intensive intendance unit by the Japanese National Infection Surveillance (JANIS). Acta Med Okayama. 2008, 62 (4): 261-26.

    PubMed  Google Scholar

16. Vergnano South, Menson E, Kennea N, Embleton N, Russell AB, Watts T, Robinson MJ, Collinson A, Heath PT: Neonatal infections in England: the NeonIT surveillance network. Curvation Dis Child Fetal Neonatal Ed. 2011, 96: F9-F1. 10.1136/adc.2009.178798.

    Commodity  PubMed  Google Scholar

17. Geffers C, Bearwolff S, Schwab F, Gastmeier P: Incidence of healthcare-associated infections in high-hazard neonates: results from the German language surveiilance arrangement for very-low-birthweight infants. J Hosp Infect. 2008, 68: 214-221. 10.1016/j.jhin.2008.01.016.

    CAS  Commodity  PubMed  Google Scholar

18. Wójkowska-Mach J, Borszewska-Kornacka M, Domańska J, Gadzinowski J, Gulczyńska East, Helwich Eastward, Kordek A, Pawlik D, Szczapa J, Klamka J, Heczko Lead: Early-onset Infections of Very-low-nascence-weight Infants in Polish Neonatal Intensive Care Units. Pediatr Infect Dis J. 2012, 31 (vii): 691-695. 10.1097/INF.0b013e3182567b74.

    Commodity  PubMed  Google Scholar

19. Gaynes RP, Edwards JR, Jarvis WR, Culver DH, Tolson JS, Martone WJ: Nosocomial infections amongst neonates in high-take chances nurseries in the United States. National Nosocomial Infections Surveillance System. Pediatrics. 1996, 98: 357-361.

    CAS  PubMed  Google Scholar

20. Lin CY, Hsu CH, Huang FY, Chang JH, Hung HY, Kao HA, Peng CC, Jim WT, Chi H, Chiu NC, Chang TY, Chen CY, Chen CP: The changing face of early on-onset neonatal sepsis afterwards the implementation of a maternal group B Streptococcus screening and intrapartum prophylaxis policy–a study in one medical center. Pediatr Neonatol. 2011, 52 (2): 78-84. 10.1016/j.pedneo.2011.02.001.

    Article  PubMed  Google Scholar

21. Shane AL, Stoll BJ: Recent developments and current issues in the epidemiology, diagnosis, and management of bacterial and fungal neonatal sepsis. Am J Perinatol. 2013, 30 (2): 131-141. ten.1055/s-0032-1333413.

    Commodity  PubMed  Google Scholar

22. Millar M, Philpott A, Wilks One thousand, Whiley A, Warwick S, Hennessy E, Coen P, Kempley S, Stacey F, Costeloe Chiliad: Colonization and persistence of antibiotic-resistant Enterobacteriaceae strains in infants nursed in two neonatal intensive care units in Due east London, United Kingdom. J Clin Microbiol. 2008, 46: 560-567. 10.1128/JCM.00832-07.

    CAS  Article  PubMed  Google Scholar

23. Shakil S, Akram M, Ali SM, Khan AU: Acquisition of extended-spectrum β-lactamase producing Escherichia coli strains in male and female person infants admitted to a neonatal intensive care unit: molecular epidemiology and analysis of risk factors. J Med Microbiol. 2010, 59: 948-954. ten.1099/jmm.0.020214-0.

    CAS  Article  PubMed  Google Scholar

24. Huang Y, Zhuang S, Du M: Take a chance factors of nosocomial infection with extended-spectrum β-lactamase-producing bacteria in a neonatal intensive care unit in Mainland china. Infection. 2007, 35: 339-345. 10.1007/s15010-007-6356-9.

    CAS  Article  PubMed  Google Scholar

25. Bromiker R, Ernest Northward, Meir MB, Kaplan M, Hammerman C, Schimmel MS, Schlesinger Y: Correlation of bacterial blazon and antibiotic sensitivity with maternal antibody exposure in early on-onset neonatal sepsis. Neonatol. 2013, 103: 48-53. 10.1159/000342215.

    CAS  Article  Google Scholar

26. Benenson Due south, Levin PD, Block C, Adler A, Ergaz Z, Peleg O, Minster Due north, Gross I, Schaffer K, Moses AE, Cohen MJ: Continuous surveillance to reduce extended-spectrum β-lactamase Klebsiella pneumoniae colonization in the neonatal intensive intendance unit. Neonatol. 2013, 103: 155-160. 10.1159/000343150.

    CAS  Article  Google Scholar

27. Denkel LA, Schwab F, Kola A, Leistner R, Garten Fifty, von Weizsäcker K, Geffers C, Gastmeier P, Piening B: The mother as well-nigh important risk factor for colonization of very depression birth weight (VLBW) infants with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-East). J Antimicrob Chemother. 2014, 69 (8): 2230-2237. ten.1093/jac/dku097.

    CAS  Article  PubMed  Google Scholar

28. Gastmeier P, Loui A, Stamm-Balderjahn S, Hansen S, Zuschneid I, Sohr D, Behnke One thousand, Obladen M, Vonberg RP, Rüden H: Outbreaks in neonatal intensive intendance units - they are not like others. Am J Infect Control. 2007, 35 (3): 172-176. x.1016/j.ajic.2006.07.007.

    Article  PubMed  Google Scholar

29. Chmielarczyk A, Pobiega Thousand, Wojkowska-Mach J, Romaniszyn D, Adamski P, Heczko Pb, Bulanda M: Molecular epidemiology, plasmid assay, virulence and resistance of Escherichia coli isolated from neonatal intensive care units in Poland. Diagn Microbiol Infect Dis. 2013, 76 (4): 542-545. x.1016/j.diagmicrobio.2013.04.016.

    CAS  Article  PubMed  Google Scholar

30. Bailey JK, Pinyon JL, Anantham S, Hall RM: Commensal Escherichia coli of healthy humans: A reservoir for antibiotic-resistance determinants. J Med Microbiol. 2010, 59 (Pt 11): 1331-1339.

    CAS  Article  PubMed  Google Scholar

Pre-publication history

• The pre-publication history for this paper can be accessed here:http://world wide web.biomedcentral.com/1471-2431/14/274/prepub

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Acknowledgements

The authors wish to thank the staff of the NICUs for their help and interest in the written report.

Funding

This study was partially supported past a grant from the Ministry building of Science and Higher Education (DEC-2011/01/D/N27/00104).

Author data

Affiliations

1. Department of Microbiology, Jagiellonian Academy Medical College, 18 Czysta Street, 31-121, Krakow, Poland

   Agnieszka Chmielarczyk, Jadwiga Wójkowska-Mach, Dorota Romaniszyn, Monika Pobiega & Piotr B Heczko

2. Institute of Nature Conservation, Smoothen Academy of Sciences, Cracow, Poland

   Paweł Adamski

3. Clinic of Neonatology and Intensive Neonatal Intendance, Institute of Mother and Child, Warsaw, Poland

   Ewa Helwich

4. Clinic of Neonatology, Jagiellonian University Medical College, Krakow, Poland

   Ryszard Lauterbach

5. Clinic of Neonatology and Intensive Neonatal Care, Warsaw Medical Academy, Warsaw, Poland

   Maria Borszewska-Kornacka

6. Clinic of Neonatology, Smooth Mothers' Memorial Hospital-Research Institute, Lodz, Poland

   Ewa Gulczyńska

7. Department of Neonatal Diseases, Pomeranian Medical University, Szczecin, Poland

   Agnieszka Kordek

Corresponding writer

Correspondence to Agnieszka Chmielarczyk.

Additional information

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

ACH carried out the molecular genetic studies (PFGE), drafted the manuscript and financially supported the written report. JWM designed the report, analysed and interpreted the epidemiological information, and drafted the manuscript. DR carried out the antimicrobial susceptibility studies. MP performed the statistical analysis and drafted the manuscript. PA performed the statistical analysis. RL, MBK, EG and AK collected and analysed the data and participated in report pattern. EH and PBH conceived the written report, participated in its design and helped to draft the manuscript. All authors read and approved the concluding manuscript for publication.

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Chmielarczyk, A., Wójkowska-Mach, J., Romaniszyn, D. et al. Mode of delivery and other risk factors for Escherichia coli infections in very depression birth weight infants. BMC Pediatr 14, 274 (2014). https://doi.org/10.1186/1471-2431-14-274

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• Received: 31 July 2014

• Accustomed: 09 October 2014

• Published: 18 October 2014

• DOI : https://doi.org/10.1186/1471-2431-14-274

Keywords

• Very low nascence weight
• Infections
• Escherichia coli
• Surveillance

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