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5 - Nosocomial infection in the neonatal intensive care unit
Ali Bülbül, Mehmet Taşdemir, Mine Pullu, Füsun Okan, Lida Bülbül, Asiye Nuhoğlu
Objective: The aim of this study was to evaluate the prevalence of nosocomial infection, distrubition and antibiotic resistance patterns of pathogen organisms in NICU (Neonatal Intensive Care Unit). Study Design: This prospective study included all neonates hospitalized in NICU for one year period. The nosocomial infection was defined as hemoculture positivity after 72 hours of hospitalization or NOSEP (Nosocomial Sepsis Prediction for Newborns) score ≥11. The antibiotic resistance of identified microorganisms were recorded. Results: In 1 year period, 1094 neonates were hospitalized. Of the 793 neonates, 675 blood cultures and 138 cultures from the other sites were collected. In 50 patients 62 hemoculture positivity were found among total hemocultures collected. Hundred and twenty four patients clinically thought to have nosocomial infection was evaluated for NOSEP criteria. In 26 neonates NOSEP score was found to be ≥11. In 138 cultures collected from the sites other than blood, 46 cultures were positive and 30 of them were accepted as nosocomial infection. According to the study criteria, 56 patients were found to have nosocomial infection. Nosocomial infection, ventilator and catheter associated nosocomial infection incidence were found to be 5.1 infection/1000 days, 1.8/1000 days and 1.6/1000 days respectively. Gram positive, gram negative bacteria and fungus were identified in 61.9%, 30.9% and 7.2% of cases respectively. The most common resistance pattern was meticilline resistance (55%) in coagulase negative staphylococci. Conclusions: The most common pathogenic agents and the most common focus of infection were gram positive bacteria and conjunctivitis respectively. The low antibiotic resistance pattern of identified microorganisms was thought to be due to the restricted use of wide spectrum antibiotics in our unit.
Keywords: Nosocomial infection, newborn, coagulase negative staphylococcus, NOSEP
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