Journal 2025 Vol.26 No.1
Prevalence of Rectal Carbapenem-Resistant Organism Colonization Among Neonates Admitted in the Neonatal Intensive Care Unit of the Philippine General Hospital
Krizia Joy A. Co, M.D., Anna Lisa T. Ong-Lim, M.D.

Abstract
Objective: To determine the prevalence of rectal colonization with carbapenem-resistant organisms (CRO) among
PGH neonatal intensive care unit (NICU) patients.
Methodology: A prospective single-center observational study conducted over a 1-month period included all NICU 3 and cohort area patients admitted on April 24, 2024. Rectal swabs were collected for multidrug-resistant organism (MDRO) screening and repeated weekly for 1 month while admitted. Swabs were inoculated on chromogenic media, and isolates were identified and tested for antimicrobial sensitivity by disk diffusion. Clinical characteristics and outcomes were collected for 30 days from initial MDRO screening. Descriptive statistics were used to summarize the data.
Results: The point prevalence of CRO colonization was 37% (14 of 38) at initial screening. There were 14 incident colonizations, hence the 4-week period prevalence of CRO colonization was 72.5% (29 of 40). The patients were mostly very preterm, very low birth weight neonates, majority were tested within the first 2 weeks of life, and half were exposed to meropenem at initial screening. Nosocomial infection developed in 29% and 64%, and 30-day mortality rate was 8% and 21% among initially non-CRO-colonized and CRO-colonized patients respectively. Despite high CRO colonization, no culture-proven CRO infection was observed. Surveillance screening documented persistent CRO colonization in 37%, but no decolonization. Escherichia coli, Klebsiella spp. and Serratia spp. were the most common colonizers.

KEYWORDS: Newborn, Carbapenem-Resistant Enterobacteriaceae, Multidrug Resistance
https://doi.org/10.56964/pidspj20252601003
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