Nosocomial Infections in Very Low Birth Weight Infants: Etiology and Risk Factors

Authors : V Vamsi SİVARAMA RAJU

Pages : 7-12

Doi:10.5799/jmid.328836

View : 7 | Download : 4

Publication Date : 2017-03-01

Article Type : Research Paper

Abstract :Objective: We aimed to find out the incidence and risk factors of nosocomial infections in VLBW neonates and to explore the microbiologic flora, sensitivity pattern and outcome. Methods: A prospective, observational study was performed in a neonatal intensive care unit of a teaching hospital. VLBW infants excluding those diagnosed with early onset sepsis, admitted to the unit between August 2012 and March 2013 were followed up for evidence of nosocomial sepsis. Results: Of 92 VLBW infants, 23 developed nosocomial sepsis, incidence rate being 25%. Decreasing birth weight insert ignore into journalissuearticles values(1251-1500 g, 10.9%; 1001-1250 g, 28%; 751-1000 g, 50%; P<.001); and gestational age insert ignore into journalissuearticles values(>33wks, 0%; 29-32wks, 21.3%; 26-28 wks, 66.7%; p<.001); were found to be associated with statistically significant increase in nosocomial sepsis rate. On multivariate logistic regression, only peripherally inserted central catheter insert ignore into journalissuearticles values(PICC); line was independently associated with increased risk of nosocomial sepsis insert ignore into journalissuearticles values(aOR 13.33, 95% CI 3.58-49.5); in VLBW. A predominance of Gram negative over Gram positive nosocomial sepsis insert ignore into journalissuearticles values(75% vs. 25%); with higher mortality in the Gram negative group insert ignore into journalissuearticles values(55% vs. 0%); was observed. Klebsiella pneumoniae was the predominant microbe insert ignore into journalissuearticles values(33.4%);. All microbes were sensitive to first line antibiotics except Elizabeth kingia meningoseptica and one episode of K. pneumoniae. Seven insert ignore into journalissuearticles values(30.4%); VLBW neonates with nosocomial sepsis died. Conclusions: Among VLBW infants, the incidence of nosocomial sepsis was 25%. Lower birth weight, lesser gestational age and PICC line were important risk factors. Gram negative nosocomial sepsis was associated with higher mortality compared to Gram positive sepsis. J Microbiol Infect Dis 2017; 7insert ignore into journalissuearticles values(1);: 7-12      
Keywords : Neonates, Nosocomial sepsis, VLBW infants