Pattern and Antimicrobial Susceptibility of Carbapenem Resistant Organisms in Tertiary Care Neonatal Intensive Care Unit, India
Bibliographic record
Abstract
Background: The emergence of carbapenem resistant organism (CRO) in the health care setting has been well-documented recently. CRO is an increasing cause of neonatal infections all over the world especially in developing countries. Objective: The aim was to study pattern, incidence, and antimicrobial sensitivity of CROs in neonatal Intensive Care Unit (NICU). Materials and Methods: We conducted a retrospective observational study between January 2011 and June 2012. The study was conducted at a tertiary level NICU. Blood cultures were done in BACTEC 9120 or brain heart agar. Culture isolates were identified by automated identification or conventional biochemical tests. Microscan 96 and/or disk diffusion method performed antibiotic susceptibility. We studied the entire Gram-negative blood culture positive isolates and also studied their antibiotic sensitivity pattern. CRO was defined by any Gram-negative isolates showing resistant to meropenem and imipenem. Results: One hundred and thirty-four babies had grown microorganisms in their blood culture. Of the 134, 77.6% ( n = 104/134) was due to Gram-negative organism infection. Among culture positive Gram-negative organisms, 14.4% ( n = 15/104) babies had carbapenem resistant Gram-negative organisms infections. Among the CRO, most common was Acinetobacter species ( n = 9), followed by Klebsiella pneumoniae ( n = 4), Escherichia coli ( n = 1), Serratia ( n = 1). CRO showed resistance to our first line, second line drugs and carbapenems. Mortality among CRO babies was 33% ( n = 5/15). Babies with nonCRO infection had 10% mortality ( n = 9/89). All CROs were sensitive to Polymyxin and colistin. Conclusion: The incidence of CRO was surprising. Polymyxin B and E (colistin) is the drug of choice for CRO. Mortality among these CROs was greater than nonCRO. Mortality caused by CRO is knocking and shocking data, indicating the emergence to check the use of antimicrobials in NICUs.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".