Impact of Colonization Pressure in Neonatal Units on the Development of Extended-Spectrum β-Lactamase Gut Colonization

By
Aislinn Cook
Matilda Berkell
C. Henri van Werkhoven
Elske Sieswerda
David R. M. Smith
Chiara Minotti
Liesbet van Heirstraeten
Elias Iosifidis
Emmanuel Roilides
Tuuli Metsvaht
Jose Ignacio Pijoan Zubizarreta
Begoña Loureiro-Gonzalez
Eric Giannoni
Chiara Messina
Surbhi Malhotra-Kumar
Julia Anna Bielicki
NeoIPC Feasibility Group
Jennifer Martin
Filip Djukic
Caridad Tapia-Collados
Eva García-Cantó
Despoina Gkentzi
Eleni Papachatzi
Varvara Dimopoulou
Charles C. Roehr
Paula Brock
Eleftheria Hatzidaki
Nicolina-Hilda Anagnostatou
Eugenio Baraldi
Elena Priante
Kosmas Sarafidis
Angeliki Kontou
Georgios Mitsiakos
Dimitra Gialamprinou
Vassiliki Papaevangelou
Maria Livieratou
Kristin Tanney
Nicola Booth
Donna Tolentino
Amy Reid
Argyro Ftergioti
Maria Simitsopoulou
Kassandra Tataropoulou
Evangelia Koemtzidou
Concepción de Alba Romero
Elena Bergon Sendin
Javier Perez-Lopez
Yolanda Campos-Franco
Aleksandra Pietrzyk
Grete Haube
Mari-Liis Ilmoja
Helgi Padari
Martin Stocker
Alexandra Périsset
Dariusz Gruszfeld
Paul Clarke
Jasmine Myhill
Fernando Cabañas
Mario Giuffrè
Veronica Notarbartolo
Sven Wellmann
Anna Badura
September 15, 2026

Jama Network Open

Overview

This study investigates the prevalence of resistant bacterial colonization among hospitalized infants in European neonatal units and quantifies the association between unit-level colonization pressure and the risk of acquiring extended-spectrum β-lactamase (ESBL)-harboring bacterial colonization.

Background

Invasive infections among neonates, particularly those born preterm, are associated with significant mortality and morbidity, including long-term neurodevelopmental impairment. The transmission of resistant bacteria in neonatal units poses a challenge for treatment and infection control.

Data Highlights

No numerical data available in the provided source material.

Key Findings

Colonization pressure is defined as the proportion of infants in a unit who are colonized with resistant bacteria.
Higher unit-level colonization pressure is associated with increased odds of individual colonization among infants.
The study involved multicenter assessments across 24 neonatal units in 8 European countries.
Infants in neonatal units are at risk of acquiring resistant bacteria due to shared environments and equipment.
Infection prevention and control measures are essential to reduce transmission events in neonatal settings.

Clinical Implications

The findings emphasize the importance of monitoring colonization pressure in neonatal units to inform infection prevention strategies. Enhanced IPC measures may be necessary to mitigate the risk of ESBL colonization and subsequent infections in vulnerable neonate populations.

Conclusion

This study underscores the critical relationship between colonization pressure and the risk of acquiring resistant bacterial colonization in neonatal units, highlighting the need for effective infection control practices.