Pathogen distribution and risk factors of nosocomial infections in neonates in the neonatal intensive care unit
YANG Ling-Rong, PENG Min-Juan, LI Hua, PANG Yi
Department of pediatrics, Chengdu Second Affiliated Hospital, Chongqing Medical University (Third People′s Hospital of Chengdu), Chengdu 610031, China. pmjuan@sohu.com
Abstract OBJECTIVE: To study the pathogen distribution and risk factors of nosocomial infections in neonates in the neonatal intensive care units (NICU). METHODS: The clinical data of 145 neonates with nosocomial infection in the NICU were retrospectively reviewed. RESULTS: Of the 145 neonates, 41 (28.3%) were infected with Klebsiella pneumoniae, 39 (26.9%) with Escherichia coli, 10 (6.9%) with Staphylococcus epidermidis, and 55 (37.9%) with other pathogens. Logistic regression analysis showed that a gestational age of ≤32 weeks (OR=5.57), birth weigh of <1500 g (OR=6.95), hospitalization time (OR=1.23), mechanical ventilation (OR=14.12) and parenteral nutrition (OR=3.01) were major risk factors for nosocomial infections caused by Klebsiella pneumoniae. The five factors were also main risk factors for nosocomial infection caused by Escherichia coli, with the OR of 3.42, 6.73, 9.96, 0.55 and 2.13 respectively. Klebsiella pneumoniae and Escherichia coli were highly resistant to β-lactam antibiotics but were relatively sensitive to levofloxacin and meropenem. CONCLUSIONS: Klebsiella pneumoniae, Escherichia coli and Staphylococcus epidermidis are major pathogens of nosocomial infections in neonates in the NICU and they are resistant to β-lactam antibiotics. Mechanical ventilation and hospitalization time are the most important risk factors for nosocomial infections caused by Klebsiella pneumoniae and Escherichia coli respectively.
YANG Ling-Rong,PENG Min-Juan,LI Hua et al. Pathogen distribution and risk factors of nosocomial infections in neonates in the neonatal intensive care unit[J]. CJCP, 2013, 15(2): 112-116.
YANG Ling-Rong,PENG Min-Juan,LI Hua et al. Pathogen distribution and risk factors of nosocomial infections in neonates in the neonatal intensive care unit[J]. CJCP, 2013, 15(2): 112-116.
[1]Bagheri Nejad S, Allegranzi B, Syed SB, Ellis B, Pittet D. Health-care-associated infection in Africa: a systematic review[J]. Bull World Health Organ, 2011, 89(10): 757-765.
[2]Combes A, Luyt CE, Trouillet JL, Nieszkowska A, Chastre J. Gender impact on the outcomes of critically ill patients with nosocomial infections[J]. Crit Care Med, 2009, 37(9): 2506-2511.
[3]Zaidi AK, Huskins WC, Thaver D, Bhutta ZA, Abbas Z, Goldmann DA. Hospital-acquired neonatal infections in developing countries[J]. Lancet, 2005, 365(9465): 1175-1188.
[4]Garcia-Hernandez AM, Garcia-Vazquez E, Hernandez-Torres A, Ruiz J, Yague G, Herrero JA, et al. Bacteraemia due to Escherichia coli producing extended-spectrum beta-lactamases (ESBL): clinical relevance and today′s insights[J]. Rev Esp Quimioter, 2011, 24(2): 57-66.
[5]Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM. CDC definitions for nosocomial infections, 1988[J]. Am J Infect Control, 1988,16(3): 128-140.
[6]Ahmad TA, El-Sayed LH, Haroun M, Hussein AA, El Ashry el SH. Development of immunization trials against klebsiella pneumoniae[J]. Vaccine, 2012, 30(14): 2411-2420.
[7]Fernández Jonusas S, Brener Dik P, Mariani G, Fustinana C, Marco Del Pont J. Nosocomial infections in a neonatal unit: surveillance program[J]. Arch Argent Pediatr, 2011, 109(5): 398-405.
[8]Amazian K, Rossello J, Castella A, Sekkat S, Terzaki S, Dhidah L, et al. Prevalence of nosocomial infections in 27 hospitals in the Mediterranean region[J]. East Mediterr Health J, 2010 16(10):1070-1078.
[9]Yapicioglu H, Ozcan K, Sertdemir Y, Mutlu B, Satar M, Narli N, et al. Healthcare-associated infections in a neonatal intensive care unit in turkey in 2008: incidence and risk factors, a prospective study[J]. J Trop Pediatr, 2011, 57(3): 157-164.
[10]Gupta A, Agrawal A, Mehrotra S, Singh A, Malik S, Khanna A. Incidence, risk stratification, antibiogram of pathogens isolated and clinical outcome of ventilator associated pneumonia[J]. Indian J Crit Care Med, 2011, 15(2): 96-101.
[11]Ghorashi Z, Nezami N, Hoseinpour-Feizi H, Ghorashi S, Tabrizi JS. Arthritis, osteomyelitis, septicemia and meningitis caused by klebsiella in a low-birth-weight newborn: a case report[J]. J Med Case Rep, 2011, 5: 241.
[12]Mushtag S, Irfan S, Sarma JB, Doumith M, Pike R, Pitout J, et al. Phylogenetic diversity of Escherichia coli strains producing NDM-type carbapenemases[J]. J Antimicrob Chemother, 2011, 66(9):2002-2005.
[13]Papadimitriou M, Voulgari E, Ranellou K, Koemtzidou E, Lebessi E, Tsakris A. Emergence of vim-1 metallo-β-lactamase-producing Escherichia coli in a neonatal intensive care unit[J]. Microb Drug Resist, 2011, 17(1): 105-108.
[14]Wu D, Cai J, Liu J. Risk factors for the acquisition of nosocomial infection with carbapenem-resistant Klebsiella pneumoniae[J]. South Med J, 2011, 104(2): 106-110.