ESBL producing gram negative bacteria infections among term and preterm newborns in neonatal intensive care unit

ABSTRACT Dr.Özgür ÖZÇEREZCİ. ESBL producing gram negative bacteria infections among term and preterm newborns in neonatal intensive care unit OBJECTIVES: To assess the incidence of ESBL-producing microorganism infections, and relationship with localization of infection, birth weight, gestational age, antibiotic susceptibility pattern and mortality among preterm and term neonates in neonatal intensive care unit. MATERIAL and METHODS: In this retrospective study, patient population was consisted of 75 newborns, hospitalized in the Neonatal Intensive Care Unit at Baskent University Hospital between June 2005 and June 2013. Patients with positive cultures for ESBL producing microorganism were included the study. Other inclusion criteria was at least 2 days monitoring in the Neonatal Intensive Care Unit RESULTS: The three most frequent types of infection in patients were bacteremia (33.0%), urinary tract infection (32.2%) and pneumonia (27.8%). No statistically significant difference was determined in the distribution of K. pneumoniae, E. coli and K. oxytoca according to gender. The majority of the culture growth (n=107, 93.0%) was positive after first 7 days of life. All isolated microorganisms were resistant to amoxicillin-clavulanate, ampicillin and ampicillin-sulbactam but sensitve to carbapenem group antibiotics. Antibiotic usage history was determined in 76% (n = 57) of patients . A statistically significant relationship was determined among clinical outcome, concomitant disease and catheter usage (p = 0.001 and 0.009). K. pneumoniae was the most fequently isolated pathogens before 2010, E.coli was the most frequent infectious agent after 2010. CONCLUSIONS: There is a relation between widespread, uncontrolled usage of broad spectrum antibiotics and high incidence of life treatening ESBL producing microorganism infection. Larger scale studies are needed to identify the relationship and risk factors for ESBL+ microorganism infections. To prevent nosocomial infections patients in the Neonatal Intensive Care Unit must be isolated and kept under detailed surveillance. Key words: ESBL, neonate, risk factors, antibiograma