期刊
SEMINARS IN FETAL & NEONATAL MEDICINE
卷 21, 期 6, 页码 388-393出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.siny.2016.06.002
关键词
Late-onset neonatal bloodstream infections; Gram-negative bacteria; Gram-positive bacteria; Gut microbes
类别
资金
- NIH [UH3AI083265, P30DK052574]
- Children's Discovery Institute of Washington University
- St Louis Children's Hospital
Late-onset neonatal bloodstream infections remain challenges in neonatology. Hand hygiene, line care, and judicious use of indwelling lines are welcome interventions, but might not reduce the incidence of late-onset neonatal bloodstream infections from bacteria originating in the gut. Accumulating data suggest that many pathogens causing late-onset neonatal bloodstream infections are of gut origin, including Gram-positive cocci. In addition to the host-canonical paradigm (i.e., all bacteria have equal risk of invasion and bloodstream infections are functions of variable infant susceptibility), we should now consider bacteria-canonical paradigms, whereby late-onset neonatal bloodstream infection is a function of colonization with a specific subset of bacteria with exceptional invasive potential. In either event, we can no longer be content to reactively approach late-onset neonatal bloodstream infections; instead we need to reduce the occurrences of these infections by broadening our scope of effort beyond line care, and determine the pre-invasive habitat of these pathogens. (C) 2016 Published by Elsevier Ltd.
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