{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T12:50:44Z","timestamp":1776084644725,"version":"3.50.1"},"reference-count":15,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":2041,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2009,6]]},"abstract":"<jats:sec id=\"S0195941700037048_abs1\"><jats:title>Background.<\/jats:title><jats:p>Although hospital-acquired infections appear to be a growing threat to the survival of newborns in the developing world, the epidemiology of this problem remains poorly characterized.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700037048_abs2\"><jats:title>Methods.<\/jats:title><jats:p>During a 10-month period, we conducted prospective longitudinal surveillance for colonization and bloodstream infection caused by gram-negative rods among all infants hospitalized in the 2 largest neonatal intensive care units in Manila, the Philippines. We determined antibiotic susceptibilities and calculated adjusted odds ratios for risk factors for bacteremia by means of multivariate logistic regression.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700037048_abs3\"><jats:title>Results.<\/jats:title><jats:p>Of 1,831 neonates enrolled during a 10-month period, 1,017 (55.5%) became newly colonized and 358 (19.6%) became bacteremic with a drug-resistant gram-negative rod, most commonly <jats:italic>Klebsiella<\/jats:italic> species, <jats:italic>Enterobacter<\/jats:italic> species, <jats:italic>Acinetobacter<\/jats:italic> species, and <jats:italic>Pseudomonas aeruginosa.<\/jats:italic> Of the invasive isolates, 20% were resistant to imipenem, 41% to trimethoprim-sulfamethoxazole, 52% to amikacin, 63% to ampicillin-sulbactam, 67% to ceftazidime, and 80% to tobramycin. The factors significantly associated with an increased risk of bacteremia were mechanical ventilation and prematurity. Additionally, colonization with a drug-resistant gram-negative rod was an independent risk factor for bacteremia (odds ratio, 1.4 [95% confidence interval, 1.0-1.9]).<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700037048_abs4\"><jats:title>Conclusions.<\/jats:title><jats:p>Colonization with a drug-resistant gram-negative rod was an independent risk factor for sepsis. If our data are typical, the unusually high intensity of colonization pressure and disease caused by multidrug-resistant gram-negative rods at these 2 neonatal intensive care units indicates an emerging healthcare crisis in the developing world. Improved infection control methods are therefore critically needed in developing countries.<\/jats:p><\/jats:sec>","DOI":"10.1086\/597512","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T00:26:29Z","timestamp":1242174389000},"page":"543-549","source":"Crossref","is-referenced-by-count":33,"title":["High Frequency of Multidrug-Resistant Gram-Negative Rods in 2 Neonatal Intensive Care Units in the Philippines"],"prefix":"10.1017","volume":"30","author":[{"given":"Jennifer M.","family":"Litzow","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher J.","family":"Gill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose B. V.","family":"Mantaring","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew P.","family":"Fox","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William B.","family":"MacLeod","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myrna","family":"Mendoza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sookee","family":"Mendoza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Scobie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles W.","family":"Huskins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald A.","family":"Goldman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David H.","family":"Hamer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2015,1,2]]},"reference":[{"key":"S0195941700037048_ref013","first-page":"629","article-title":"Neonatal sepsis in hospital-born babies: bacterial isolates and antibiotic susceptibility patterns","volume":"13","author":"Aurangzeb","year":"2003","journal-title":"J Coll Physicians Surg Pak"},{"key":"S0195941700037048_ref014","doi-asserted-by":"publisher","DOI":"10.1080\/02724930120077835"},{"key":"S0195941700037048_ref006","doi-asserted-by":"publisher","DOI":"10.2307\/30142004"},{"key":"S0195941700037048_ref010","doi-asserted-by":"publisher","DOI":"10.1086\/594120"},{"key":"S0195941700037048_ref003","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/49.5.295"},{"key":"S0195941700037048_ref002","doi-asserted-by":"publisher","DOI":"10.2307\/30141533"},{"key":"S0195941700037048_ref009","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)71881-X"},{"key":"S0195941700037048_ref001","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)71048-5"},{"key":"S0195941700037048_ref015","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/46.2.86"},{"key":"S0195941700037048_ref011","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)90015-1"},{"key":"S0195941700037048_ref012","first-page":"9","article-title":"Neonatal sepsis: the antibiotic crisis","volume":"42","author":"Isaacs","year":"2005","journal-title":"Indian Pediatr"},{"key":"S0195941700037048_ref007","first-page":"310","article-title":"Neonatal intensive care unit: reservoirs of nosocomial pathogens","volume":"21","author":"Newman","year":"2002","journal-title":"West Afr J Med"},{"key":"S0195941700037048_ref008","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2002.022863"},{"key":"S0195941700037048_ref005","doi-asserted-by":"publisher","DOI":"10.1097\/01.inf.0000172150.66717.92"},{"key":"S0195941700037048_ref004","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7211283"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0195941700037048","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T09:15:29Z","timestamp":1556615729000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0195941700037048\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,6]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2009,6]]}},"alternative-id":["S0195941700037048"],"URL":"https:\/\/doi.org\/10.1086\/597512","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,6]]}}}