The effect of healthcare associated infections and antibiotic use in newborn period on atopic diseases in early childhood

Aim: Our aim was to investigate the effect of healthcare associated infections and antibiotic use in newborn period on atopic diseases.Material and Methods: 73 children who were treated for healthcare associated infections in newborn period in Çukurova University, Neonatal Intensive Care Unit between January 2001 and September 2007, and their 41 siblings who were healthy in newborn period were included to the study. For atopic disease evaluation children?s parents answered a detailed questionnaire, children were examined and complete blood count, total Ig E, specific Ig E, hx2 and fx5 levels were studied. For atopic evaluation of mothers, Ig E levels were withdrawn.Results: Ventilator associated pneumonia was observed in 32 (45.2%), blood stream infection in 28 (38.4%) and clinic sepsis in 12 (16.4%) of 73 children with healthcare associated infections. Atopic diseases were higher (37.0%) in children with healthcare associated infections (p<0.001). There was asthma in 24 (32.9%) children, allergic rhinitis in 3 (4.1%) and atopic dermatitis in 5 (6.8%) children in healthcare associated infections group. However, 2 children (4.9%) had asthma, 1 child had allergic rhinitis (2.4%) and totally 2 children (4.9%) had at least one atopic disease in sibling group. Asthma was significantly higher in healthcare associated infections group compared to sibling group (p<0.001), but there was no significant difference in allergic rhinitis and atopic dermatitis (p=0.999, p=0.158) among groups. Although there was no difference in eosinophil counts, specific IgE levels, hx2 and fx5 levels; total IgE levels were significantly higher in healthcare associated infections group (p=0.003). There was no significant difference in atopic diseases between patients with ventilator associated pneumonia and blood stream infection in healthcare associated infections group (p=0.309). When we compared atopic 29 children with non-atopic 85 children, children who had been hospitalized and treated with antibiotics in newborn period were almost 11.5 times as likely to have atopic disease.Conclusion: Atopic diseases and asthma were significantly higher in healthcare associated infections group, and atopic disease risk seems to be increased in children who were treated with antibiotics for healthcare associated infections in newborn period.Key Words: Antibiotics, atopic disease, healthcare associated infection, newborn period.