Infection rates in surgical neonates and XXXX receiving parenteral nutrition: a five-year prospective study.

@entity1 @entity295
We performed a prospective, observational, cohort study on 208 surgical neonates and @entity1 between 1992 and 1997. Surveillance cultures of the oropharynx and rectum were obtained at the start of parenteral nutrition and thereafter twice weekly. Blood cultures were taken on clinical indication only. Microbial translocation was diagnosed when the micro-organisms in the blood were not distinguishable from those carried in the oropharynx and/or rectum. Liver function was monitored weekly and when @entity295 was suspected. The incidence of @entity295 was 15%. The predominant micro-organisms (86%) were the low-level pathogens, coagulase-negative staphylococci and enterococci. Potential pathogens, including aerobic Gram-negative bacilli, were responsible for the remainder. Microbial translocation was responsible for 84% of septicaemic episodes in 76% of @entity1 . The potential pathogens caused @entity295 significantly later than coagulase-negative staphylococci, at a time when liver function was significantly more impaired. In neonates and @entity1 receiving parenteral nutrition, @entity295 is mainly a gut-derived phenomenon and requires novel strategies for prevention.
