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Aetiology and frequency of risk factors for late onset neonatal sepsis in a level IIIBb NICU
Etiología y frecuencia de factores de riesgo de sepsis tardía en una unidad de cuidados intensivos neonatales de nivel IIIb
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LOS is generally nosocomial.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> In the latest Spanish study on LOS,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> 730 cases of sepsis were diagnosed in 662 newborns out of a total of 30,993 hospitalised newborns. This gives an incidence of 2.4%, and an incidence density rate of 0.89 per 1000 days of admission. At present, nosocomial infections are the leading cause of morbidity and mortality in neonatal units (10–15%).<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We present a retrospective, descriptive study conducted in a level IIIB neonatal intensive care unit (NICU) that included all patients admitted between January 1, 2010 and December 31, 2014 with a positive blood culture and a diagnosis of LOS according to the Centre for Disease Control and Prevention (CDC) criteria.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> In patients with suspected LOS, at least 1<span class="elsevierStyleHsp" style=""></span>ml of blood was collected and introduced into a paediatric BD BACTEC Peds Plus/F blood culture bottle (Becton Dickinson, USA) and incubated in the Bactec FX automated system for up to 5 days. Positive samples were then reseeded in standard media and analysed using mass spectrometry (MALDI-tof, Bruker Diagnostics, Germany). Isolates were confirmed against the antibiogram using the Microscan system (Beckman Coulter, USA). The study was approved by our hospital's Ethics Committee.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We observed an incidence of LOS of 6.8%, with an incidence density of 4 cases per 1000 days of admission. The median weight at birth was 1420<span class="elsevierStyleHsp" style=""></span>g (interquartile range [IQR]: 990–2310<span class="elsevierStyleHsp" style=""></span>g) and mean gestational age was 31 weeks (95% confidence interval [95% CI] 23–40.5). The median days of life at onset was 10 (IQR: 6–22). In total, 99 patients (67%) received parenteral nutrition (median duration of 8 days, IQR: 5–14) for other reasons at the time of onset of the infectious disease; 35 patients (24%) were intubated (median duration of 7 days, IQR: 5–26) before onset of LOS and 135 patients (92%) had a central venous catheter (median duration of 10 days, IQR: 6–23) at the time of onset of sepsis symptoms. The median length of hospital stay was 39 days (IQR: 19–63).</p><p id="par0020" class="elsevierStylePara elsevierViewall">The most frequently isolated microorganisms were: <span class="elsevierStyleItalic">Staphylococcus epidermidis</span> 30% (44/147), <span class="elsevierStyleItalic">Klebsiella pneumoniae</span> (<span class="elsevierStyleItalic">K. pneumoniae</span>) 14% (21/147), <span class="elsevierStyleItalic">Escherichia coli</span> 8% (12/147), <span class="elsevierStyleItalic">Enterobacter cloacae</span> (<span class="elsevierStyleItalic">E. cloacae</span>) 7.5% (11/147), <span class="elsevierStyleItalic">Staphylococcus haemolyticus</span> 5% (7/147), <span class="elsevierStyleItalic">Klebsiella oxytoca</span> 5% (7/147), <span class="elsevierStyleItalic">Staphylococcus hominis</span> 4% (6/147), <span class="elsevierStyleItalic">Candida albicans</span> 4% (6/147), <span class="elsevierStyleItalic">Candida parapsilosis</span> 4% (6/147), <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> (<span class="elsevierStyleItalic">P. aeruginosa</span>) 4% (6/147), <span class="elsevierStyleItalic">Staphylococcus capitis</span> 3% (4/147) and <span class="elsevierStyleItalic">Enterococcus faecalis</span> 2% (3/147). The antibiotic sensitivities of these bacteria are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. Eight cases of extended-spectrum beta-lactamase (ESBL) producing <span class="elsevierStyleItalic">E. cloacae</span> (73%) and 5 of ESBL-producing <span class="elsevierStyleItalic">K. pneumoniae</span> (24%) were found among the isolates.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The prevalence of LOS varied greatly (up to 4.9% or up to 3.8 cases per thousand days of admission).<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,2</span></a> Although our figures are slightly higher, they were influenced by the ESBL <span class="elsevierStyleItalic">E. cloacae</span> outbreak in 2011 involving a total of 8 patients and 2 fatalities. Had the average of 2.5 cases occurred in any other year, our incidence density would be 3.2 cases per 1000 days of admission.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The most important factor in the development of LOS was venous catheters, which were used in the vast majority of our patients for a duration similar to that reported in the literature.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> Symptoms, however, appear earlier in our centre.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> This could be related to catheter management. In half of all cases, parenteral nutrition was scheduled to be withdrawn over the following days, which could also be a point of improvement, despite the fact that duration of parenteral nutrition in our hospital is similar to or even better than that of other centres.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Use of endotracheal intubation in our centre does not differ from earlier studies.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Due to the aforementioned outbreak, the relative frequency of <span class="elsevierStyleItalic">E. cloacae</span> in our hospital is slightly higher than other centres,<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> but no significant differences were observed in the frequency of other microorganisms.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The sensitivity profile of our gram-positive bacteria was largely similar to that observed in other non-Anglo-Saxon countries.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> Gram-negative bacteria, even with a good profile for <span class="elsevierStyleItalic">P. aeruginosa</span>, show greater sensitivity to aminoglycosides (75%) than that described in developing countries,<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> but far less than susceptibility data from developed countries.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> The sensitivity to carbapenems was higher (93%) than that reported in the literature,<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> even though we observed several cases of drug-resistant <span class="elsevierStyleItalic">E. cloacae</span> and <span class="elsevierStyleItalic">P. aeruginosa</span>. With regard to cephalosporins, bacteria showed high sensitivity to cefepime (76.5%),<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> but not to cefotaxime. This could also be due to the presence of several ESBL-producing strains.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Alonso-Ojembarrena A, Marín-Lozano ÁC, Galán-Sánchez F, Rodríguez-Iglesias MA. Etiología y frecuencia de factores de riesgo de sepsis tardía en una unidad de cuidados intensivos neonatales de nivel IIIb. Enferm Infecc Microbiol Clin. 2018;36:144–145.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">S. epidermidis</span><br>(n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>44) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Other CNS<br>(n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>17) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">K. pneumoniae</span><br>(n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>21) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">E. coli</span><br>(n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>12) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">E. cloacae</span><br>(n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>11) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">K. oxytoca</span><br>(n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>7) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P. aeruginosa</span><br>(n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>6) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Amoxi-clav. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">75% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gentamicin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">83% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">73% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">83.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Amikacin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">95% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">83% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">81.8% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">83.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tobramycin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">83% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">63.7% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Daptomycin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Penicillin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Vancomycin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Teicoplanin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Linezolid \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Rifampicin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">98% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Oxacillin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pipera-taz. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">90% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">82% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ceftazidime \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">81% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">64% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cefotaxime \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">76% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">55% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cefepime \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">76% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">64% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Meropenem \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">91% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">83.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1673979.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Percentage of antimicrobial sensitivity of the most frequently isolated bacteria.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Early and late onset sepsis in very-low-birth weight infants from a large group of Neonatal Intensive Care Units" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.P. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 0 | 3 |
| 2024 October | 17 | 5 | 22 |
| 2024 September | 20 | 7 | 27 |
| 2024 August | 18 | 6 | 24 |
| 2024 July | 16 | 6 | 22 |
| 2024 June | 25 | 4 | 29 |
| 2024 May | 18 | 9 | 27 |
| 2024 April | 33 | 23 | 56 |
| 2024 March | 22 | 6 | 28 |
| 2024 February | 6 | 3 | 9 |
| 2024 January | 17 | 3 | 20 |
| 2023 December | 14 | 4 | 18 |
| 2023 November | 12 | 10 | 22 |
| 2023 October | 12 | 10 | 22 |
| 2023 September | 7 | 2 | 9 |
| 2023 August | 12 | 2 | 14 |
| 2023 July | 5 | 6 | 11 |
| 2023 June | 17 | 0 | 17 |
| 2023 May | 40 | 0 | 40 |
| 2023 April | 32 | 1 | 33 |
| 2023 March | 13 | 2 | 15 |
| 2023 February | 10 | 4 | 14 |
| 2023 January | 10 | 4 | 14 |
| 2022 December | 27 | 8 | 35 |
| 2022 November | 16 | 6 | 22 |
| 2022 October | 21 | 15 | 36 |
| 2022 September | 16 | 10 | 26 |
| 2022 August | 20 | 6 | 26 |
| 2022 July | 24 | 4 | 28 |
| 2022 June | 24 | 5 | 29 |
| 2022 May | 27 | 9 | 36 |
| 2022 April | 38 | 5 | 43 |
| 2022 March | 64 | 6 | 70 |
| 2022 February | 57 | 6 | 63 |
| 2022 January | 39 | 7 | 46 |
| 2021 December | 31 | 12 | 43 |
| 2021 November | 36 | 7 | 43 |
| 2021 October | 8 | 10 | 18 |
| 2021 September | 9 | 10 | 19 |
| 2021 August | 14 | 13 | 27 |
| 2021 July | 10 | 8 | 18 |
| 2021 June | 14 | 12 | 26 |
| 2021 May | 12 | 7 | 19 |
| 2021 April | 17 | 21 | 38 |
| 2021 March | 25 | 8 | 33 |
| 2021 February | 9 | 6 | 15 |
| 2021 January | 8 | 8 | 16 |
| 2020 December | 6 | 6 | 12 |
| 2020 November | 11 | 13 | 24 |
| 2020 October | 4 | 4 | 8 |
| 2020 September | 12 | 8 | 20 |
| 2020 August | 11 | 5 | 16 |
| 2020 July | 6 | 3 | 9 |
| 2020 June | 9 | 5 | 14 |
| 2020 May | 11 | 7 | 18 |
| 2020 April | 4 | 1 | 5 |
| 2020 March | 5 | 2 | 7 |
| 2020 February | 7 | 3 | 10 |
| 2020 January | 7 | 2 | 9 |
| 2019 December | 13 | 5 | 18 |
| 2019 November | 10 | 3 | 13 |
| 2019 October | 11 | 6 | 17 |
| 2019 September | 3 | 1 | 4 |
| 2019 August | 3 | 0 | 3 |
| 2019 July | 10 | 7 | 17 |
| 2019 June | 23 | 6 | 29 |
| 2019 May | 96 | 2 | 98 |
| 2019 April | 17 | 3 | 20 |
| 2019 March | 6 | 4 | 10 |
| 2019 February | 7 | 3 | 10 |
| 2019 January | 3 | 2 | 5 |
| 2018 December | 2 | 3 | 5 |
| 2018 November | 4 | 0 | 4 |
| 2018 October | 3 | 11 | 14 |
| 2018 September | 8 | 0 | 8 |
| 2018 August | 3 | 0 | 3 |
| 2018 February | 2 | 0 | 2 |
Show all
