Bacterial colonisation of the endotracheal tube in ventilated very preterm neonates: A retrospective cohort study
Aim To determine the rate, type and timing of bacterial endotracheal tube (ETT) colonisation in neonates born
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| Veröffentlicht in: | Journal of paediatrics and child health 2020-10, Vol.56 (10), p.1607-1612 |
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| container_title | Journal of paediatrics and child health |
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| creator | Antoine, Jasmine Inglis, Garry D T Way, Mandy O'Rourke, Peter Davies, Mark W |
| description | Aim
To determine the rate, type and timing of bacterial endotracheal tube (ETT) colonisation in neonates born |
| doi_str_mv | 10.1111/jpc.15046 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmed_primary_32808358</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2453926545</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3536-95c4470bbd2433e3ba583fb628a89bf6fc9b94ad271d92c9b554211bedd6f50f3</originalsourceid><addsrcrecordid>eNqNkU2LFDEQhoMo7jp68A9IwIsivZvPnrS3tfGTBT3ouUnS1UyGnmQ2Sa_Mv7fcGfcgCOZSleKplzd5CXnO2QXHc7nd-wuumWofkHOuFGv4WquH2DOpGmU4OyNPStkyxoTW5jE5k8IwI7U5JzfvrK-Qg52pT3OKodgaUqRponUDFOKYarZ-AwjUxQENkd5CrGG2FUZs84HuM6DEjkZIEaflLb2iOMqp7MHXcAsovUm50lKX8fCUPJrsXODZqa7Ijw_vv_efmuuvHz_3V9eNl1q2Tae9Umvm3CiUlCCd1UZOrhXGms5N7eQ71yk7ijUfO4EXrZXg3ME4tpNmk1yRV0fdfU43C5Q67ELxMM8WfS5lQFnNjWm5QfTlX-g2LTmiO6S07ESrsazI6yPl8WUlwzTsc9jZfBg4G37nMGAOw10OyL44KS5uB-M9-efjETBH4Ce4NBUfIHq4xzAp3TIhtMGO8T7Uu1T6tMSKq2_-fxXpyxMdZjj82_Lw5Vt_9P4LxgSzlQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2453926545</pqid></control><display><type>article</type><title>Bacterial colonisation of the endotracheal tube in ventilated very preterm neonates: A retrospective cohort study</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Antoine, Jasmine ; Inglis, Garry D T ; Way, Mandy ; O'Rourke, Peter ; Davies, Mark W</creator><creatorcontrib>Antoine, Jasmine ; Inglis, Garry D T ; Way, Mandy ; O'Rourke, Peter ; Davies, Mark W</creatorcontrib><description>Aim
To determine the rate, type and timing of bacterial endotracheal tube (ETT) colonisation in neonates born <32 weeks gestational age (GA); and if bacterial colonisation is associated with chronic lung disease (CLD), septicaemia, length‐of‐stay or mortality.
Methods
All intubated newborns born <32 weeks GA were included. Endotracheal aspirates were routinely obtained three times‐per‐week. Cohort was divided into three colonisation groups: no growth, normal respiratory flora only, significant bacteria. Logistic regression was performed to identify if ETT bacterial colonisation was associated with CLD, septicaemia or mortality. A general linear model was fitted for length‐of‐stay.
Results
ETT aspirates were sent from 1054 infants: no growth n = 319, only normal respiratory flora n = 357, and significant bacteria n = 378. ETTs became colonised in 70%, most in the first week of life (82%). Most grew normal respiratory flora (642 infants). In those with significant bacteria, 40% grew Gram‐negative species; Klebsiella in 34%. Staphylococcus aureus grew in 104 patients. Adjusted odds ratios for CLD (43% of cohort) compared with no growth were, for normal respiratory flora, 0.58 (95% confidence interval (CI) 0.34–0.99) and, for significant bacteria, 0.48 (95% CI 0.24–0.93). With no overall association between colonisation group and CLD in the adjusted model P = 0.07. The odds of septicaemia (10% of cohort) were 4.50 (95% CI 1.98–10.23, P < 0.001) times greater for significant bacteria compared with no growth. No significant associated was found with mortality or length‐of‐stay.
Conclusions
Bacterial colonisation of ETTs is common. It is associated with more septicaemia. There was no significant association with CLD, longer admission or mortality.</description><identifier>ISSN: 1034-4810</identifier><identifier>EISSN: 1440-1754</identifier><identifier>DOI: 10.1111/jpc.15046</identifier><identifier>PMID: 32808358</identifier><language>eng</language><publisher>Australia: John Wiley & Sons Australia, Ltd</publisher><subject>Bacteria ; Cohort analysis ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; infection ; intratracheal ; Intubation ; Intubation, Intratracheal ; Life Sciences & Biomedicine ; Lung Diseases ; Mortality ; Neonatal care ; newborn ; Newborn babies ; Nosocomial infections ; Pediatrics ; Premature babies ; respiration ; Respiration, Artificial ; Retrospective Studies ; Science & Technology ; Ventilators</subject><ispartof>Journal of paediatrics and child health, 2020-10, Vol.56 (10), p.1607-1612</ispartof><rights>2020 Paediatrics and Child Health Division (The Royal Australasian College of Physicians)</rights><rights>2020 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>6</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000560225800001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c3536-95c4470bbd2433e3ba583fb628a89bf6fc9b94ad271d92c9b554211bedd6f50f3</citedby><cites>FETCH-LOGICAL-c3536-95c4470bbd2433e3ba583fb628a89bf6fc9b94ad271d92c9b554211bedd6f50f3</cites><orcidid>0000-0003-2179-4367 ; 0000-0003-4428-2778</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjpc.15046$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjpc.15046$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,28253,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32808358$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Antoine, Jasmine</creatorcontrib><creatorcontrib>Inglis, Garry D T</creatorcontrib><creatorcontrib>Way, Mandy</creatorcontrib><creatorcontrib>O'Rourke, Peter</creatorcontrib><creatorcontrib>Davies, Mark W</creatorcontrib><title>Bacterial colonisation of the endotracheal tube in ventilated very preterm neonates: A retrospective cohort study</title><title>Journal of paediatrics and child health</title><addtitle>J PAEDIATR CHILD H</addtitle><addtitle>J Paediatr Child Health</addtitle><description>Aim
To determine the rate, type and timing of bacterial endotracheal tube (ETT) colonisation in neonates born <32 weeks gestational age (GA); and if bacterial colonisation is associated with chronic lung disease (CLD), septicaemia, length‐of‐stay or mortality.
Methods
All intubated newborns born <32 weeks GA were included. Endotracheal aspirates were routinely obtained three times‐per‐week. Cohort was divided into three colonisation groups: no growth, normal respiratory flora only, significant bacteria. Logistic regression was performed to identify if ETT bacterial colonisation was associated with CLD, septicaemia or mortality. A general linear model was fitted for length‐of‐stay.
Results
ETT aspirates were sent from 1054 infants: no growth n = 319, only normal respiratory flora n = 357, and significant bacteria n = 378. ETTs became colonised in 70%, most in the first week of life (82%). Most grew normal respiratory flora (642 infants). In those with significant bacteria, 40% grew Gram‐negative species; Klebsiella in 34%. Staphylococcus aureus grew in 104 patients. Adjusted odds ratios for CLD (43% of cohort) compared with no growth were, for normal respiratory flora, 0.58 (95% confidence interval (CI) 0.34–0.99) and, for significant bacteria, 0.48 (95% CI 0.24–0.93). With no overall association between colonisation group and CLD in the adjusted model P = 0.07. The odds of septicaemia (10% of cohort) were 4.50 (95% CI 1.98–10.23, P < 0.001) times greater for significant bacteria compared with no growth. No significant associated was found with mortality or length‐of‐stay.
Conclusions
Bacterial colonisation of ETTs is common. It is associated with more septicaemia. There was no significant association with CLD, longer admission or mortality.</description><subject>Bacteria</subject><subject>Cohort analysis</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Extremely Premature</subject><subject>Infant, Newborn</subject><subject>infection</subject><subject>intratracheal</subject><subject>Intubation</subject><subject>Intubation, Intratracheal</subject><subject>Life Sciences & Biomedicine</subject><subject>Lung Diseases</subject><subject>Mortality</subject><subject>Neonatal care</subject><subject>newborn</subject><subject>Newborn babies</subject><subject>Nosocomial infections</subject><subject>Pediatrics</subject><subject>Premature babies</subject><subject>respiration</subject><subject>Respiration, Artificial</subject><subject>Retrospective Studies</subject><subject>Science & Technology</subject><subject>Ventilators</subject><issn>1034-4810</issn><issn>1440-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><recordid>eNqNkU2LFDEQhoMo7jp68A9IwIsivZvPnrS3tfGTBT3ouUnS1UyGnmQ2Sa_Mv7fcGfcgCOZSleKplzd5CXnO2QXHc7nd-wuumWofkHOuFGv4WquH2DOpGmU4OyNPStkyxoTW5jE5k8IwI7U5JzfvrK-Qg52pT3OKodgaUqRponUDFOKYarZ-AwjUxQENkd5CrGG2FUZs84HuM6DEjkZIEaflLb2iOMqp7MHXcAsovUm50lKX8fCUPJrsXODZqa7Ijw_vv_efmuuvHz_3V9eNl1q2Tae9Umvm3CiUlCCd1UZOrhXGms5N7eQ71yk7ijUfO4EXrZXg3ME4tpNmk1yRV0fdfU43C5Q67ELxMM8WfS5lQFnNjWm5QfTlX-g2LTmiO6S07ESrsazI6yPl8WUlwzTsc9jZfBg4G37nMGAOw10OyL44KS5uB-M9-efjETBH4Ce4NBUfIHq4xzAp3TIhtMGO8T7Uu1T6tMSKq2_-fxXpyxMdZjj82_Lw5Vt_9P4LxgSzlQ</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Antoine, Jasmine</creator><creator>Inglis, Garry D T</creator><creator>Way, Mandy</creator><creator>O'Rourke, Peter</creator><creator>Davies, Mark W</creator><general>John Wiley & Sons Australia, Ltd</general><general>Wiley</general><general>Blackwell Publishing Ltd</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2179-4367</orcidid><orcidid>https://orcid.org/0000-0003-4428-2778</orcidid></search><sort><creationdate>202010</creationdate><title>Bacterial colonisation of the endotracheal tube in ventilated very preterm neonates: A retrospective cohort study</title><author>Antoine, Jasmine ; Inglis, Garry D T ; Way, Mandy ; O'Rourke, Peter ; Davies, Mark W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3536-95c4470bbd2433e3ba583fb628a89bf6fc9b94ad271d92c9b554211bedd6f50f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Bacteria</topic><topic>Cohort analysis</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Extremely Premature</topic><topic>Infant, Newborn</topic><topic>infection</topic><topic>intratracheal</topic><topic>Intubation</topic><topic>Intubation, Intratracheal</topic><topic>Life Sciences & Biomedicine</topic><topic>Lung Diseases</topic><topic>Mortality</topic><topic>Neonatal care</topic><topic>newborn</topic><topic>Newborn babies</topic><topic>Nosocomial infections</topic><topic>Pediatrics</topic><topic>Premature babies</topic><topic>respiration</topic><topic>Respiration, Artificial</topic><topic>Retrospective Studies</topic><topic>Science & Technology</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Antoine, Jasmine</creatorcontrib><creatorcontrib>Inglis, Garry D T</creatorcontrib><creatorcontrib>Way, Mandy</creatorcontrib><creatorcontrib>O'Rourke, Peter</creatorcontrib><creatorcontrib>Davies, Mark W</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of paediatrics and child health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Antoine, Jasmine</au><au>Inglis, Garry D T</au><au>Way, Mandy</au><au>O'Rourke, Peter</au><au>Davies, Mark W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bacterial colonisation of the endotracheal tube in ventilated very preterm neonates: A retrospective cohort study</atitle><jtitle>Journal of paediatrics and child health</jtitle><stitle>J PAEDIATR CHILD H</stitle><addtitle>J Paediatr Child Health</addtitle><date>2020-10</date><risdate>2020</risdate><volume>56</volume><issue>10</issue><spage>1607</spage><epage>1612</epage><pages>1607-1612</pages><issn>1034-4810</issn><eissn>1440-1754</eissn><abstract>Aim
To determine the rate, type and timing of bacterial endotracheal tube (ETT) colonisation in neonates born <32 weeks gestational age (GA); and if bacterial colonisation is associated with chronic lung disease (CLD), septicaemia, length‐of‐stay or mortality.
Methods
All intubated newborns born <32 weeks GA were included. Endotracheal aspirates were routinely obtained three times‐per‐week. Cohort was divided into three colonisation groups: no growth, normal respiratory flora only, significant bacteria. Logistic regression was performed to identify if ETT bacterial colonisation was associated with CLD, septicaemia or mortality. A general linear model was fitted for length‐of‐stay.
Results
ETT aspirates were sent from 1054 infants: no growth n = 319, only normal respiratory flora n = 357, and significant bacteria n = 378. ETTs became colonised in 70%, most in the first week of life (82%). Most grew normal respiratory flora (642 infants). In those with significant bacteria, 40% grew Gram‐negative species; Klebsiella in 34%. Staphylococcus aureus grew in 104 patients. Adjusted odds ratios for CLD (43% of cohort) compared with no growth were, for normal respiratory flora, 0.58 (95% confidence interval (CI) 0.34–0.99) and, for significant bacteria, 0.48 (95% CI 0.24–0.93). With no overall association between colonisation group and CLD in the adjusted model P = 0.07. The odds of septicaemia (10% of cohort) were 4.50 (95% CI 1.98–10.23, P < 0.001) times greater for significant bacteria compared with no growth. No significant associated was found with mortality or length‐of‐stay.
Conclusions
Bacterial colonisation of ETTs is common. It is associated with more septicaemia. There was no significant association with CLD, longer admission or mortality.</abstract><cop>Australia</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>32808358</pmid><doi>10.1111/jpc.15046</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-2179-4367</orcidid><orcidid>https://orcid.org/0000-0003-4428-2778</orcidid></addata></record> |
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| subjects | Bacteria Cohort analysis Humans Infant Infant, Extremely Premature Infant, Newborn infection intratracheal Intubation Intubation, Intratracheal Life Sciences & Biomedicine Lung Diseases Mortality Neonatal care newborn Newborn babies Nosocomial infections Pediatrics Premature babies respiration Respiration, Artificial Retrospective Studies Science & Technology Ventilators |
| title | Bacterial colonisation of the endotracheal tube in ventilated very preterm neonates: A retrospective cohort study |
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