Unit Colonization Pressure Drives Neonatal ESBL Gut Acquisition

This multinational neonatal surveillance study quantifies how ward-level extended-spectrum beta-lactamase colonization prevalence raises individual infant acquisition risk, reinforcing unit-wide infection prevention over infant-specific targeting alone.

ESBLextended-spectrum beta-lactamaseblaCTX-Mneonatal intensive carecolonization pressureinfection prevention and controlantimicrobial resistancesurveillanceNeoIPCNeoDecoobservational studygut colonization Infectious Disease / Antimicrobials

Background Information

ESBL colonization pressure boosts infant infection risk in neonatal units.

Neonatal units face challenges with antibiotic-resistant bacteria, affecting infection prevention and control strategies. Higher ESBL (extended-spectrum β-lactamase) colonization pressure significantly increased the risk of individual infant colonization, with odds ratios of 1.89, 1.76, and 1.73 over 4-, 7-, and 14-day intervals respectively. The study highlights the need for unit-level interventions focusing on colonization management to mitigate ESBL spread in high-pressure neonatal units, though applicability may vary by region. Higher ESBL colonization pressure increases infant colonization risk, suggesting targeted interventions in neonatal units.

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Authors: Cook A, Berkell M, van Werkhoven CH, Sieswerda E, Smith DRM, Minotti C, van Heirstraeten L, Iosifidis E, Roilides E, Metsvaht T, Pijoan Zubizarreta JI, Loureiro-Gonzalez B, Giannoni E, Messina C, Malhotra-Kumar S, Bielicki JA, NeoIPC Feasibility Group, Martin J, Djukic F, Tapia-Collados C, García-Cantó E, Gkentzi D, Papachatzi E, Dimopoulou V, Roehr CC, Brock P, Hatzidaki E, Anagnostatou NH, Baraldi E, Priante E, Sarafidis K, Kontou A, Mitsiakos G, Gialamprinou D, Papaevangelou V, Livieratou M, Tanney K, Booth N, Tolentino D, Reid A, Ftergioti A, Simitsopoulou M, Tataropoulou K, Koemtzidou E, de Alba Romero C, Sendin EB, Perez-Lopez J, Campos-Franco Y, Pietrzyk A, Haube G, Ilmoja ML, Padari H, Stocker M, Périsset A, Gruszfeld D, Clarke P, Myhill J, Cabañas F, Giuffrè M, Notarbartolo V, Wellmann S, Badura A

Citation: Cook A, Berkell M, van Werkhoven CH, et al. Neonatal Unit Colonization Pressure and Acquisition of Extended-Spectrum β-Lactamase Gut Colonization. JAMA network open. 2026;9(9):e2632644. doi:10.1001/jamanetworkopen.2026.32644

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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