Bacterial Infections and Relevant Factors in Neonates Hospitalized at Intensive Care Unit

Document Type : Original Article

Authors

1 Faculty of medicine, Mazandaran University of medical silences, sari, Iran.

2 Division of pediatric pulmonary and sleep medicine, Emam hossein children,s hospital, research institute for primordial prevention of non communicable disease, child growh and development research center,Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of pediatrics, ramsar campus, Mazandaran University of medical sciences, sari, Iran.

4 Neonatal Research Center, Akbar Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

5 Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Among the most common causes of death in preterm infants are neonatal infections, which remain high despite antibiotic therapy and preservative measures. The control of hospital infections is now a global priority, and many factors contribute to the spread of these infections. This study aimed to determine the frequency of bacterial infections in neonates and identify the common causes of infection in neonates admitted to the neonatal intensive care unit (NICU) of Alzahra Hospital in Isfahan, Iran.
Methods: In this cross-sectional study, the population consisted of all neonates who were admitted to the NICU of Al-Zahra Hospital in Isfahan, Iran, from April 2017 to March 2018. Neonates who had a positive culture (blood, cerebrospinal fluid, urine, eye discharge, and tracheal tube secretions) were enrolled. The data were collected by a structured questionnaire, including maternal and neonatal information.
Results: In this study, 56 newborns admitted to the NICU of Alzahra Hospital in Isfahan were studied. Their age range was within 5-28 days (18.88±8.41). Thirty-two (57.1%) neonates were male, and 24 (42.9%) newborns were female. In total, 26 (46.4%) neonates had prematurity that was the most common reason for hospitalization. The most isolated microorganisms were Staphylococcus epidermidis, Enterococcus, Klebsiella, Enterobacteriaceae, Candida spp., Acinetobacter, Streptococcus pneumoniae, E. coli, and Streptococcus viridans, respectively.
Conclusion: According to the results of this study, the frequency of nosocomial infections in the NICU of Alzahra Hospital in Isfahan was 7.4%. The findings of this study highlighted the importance of paying more attention to controlling and preventing hospital infections in NICUs.

Keywords

References

1. Falhammar H, Filipsson H, Holmdahl G, Janson PO, Nordenskjö ld A, Hagenfeldt K, et al. Metabolic profile and body composition in adult women with congenital adrenal hyperplasia due to 21- hydroxylase deficiency. J Clin Endocrinol Metab. 2007; 92(1):110-6.
 2. Barbara J, Behrman R, Kliegman R, Jenson H. Infections of the neonatal infant. Nelson textbook of pediatrics. Philadelphia: WB Saunders CO; 2008. P. 794-811.
3. Reuben K, Mervin C, Richard A. The immune system. In: Fanarroff AA, Martin RJ, editors. Neonatal– perinatal medicine. 8th ed. Philadelphia: Mosby; 2006. P. 676-755.
4. Babaei H, Alipour AA, Ghadiri K, Abdollahzadeh AM, Rezaei M. The effect of intravenous immunoglobulin on admission duration and mortality rate related to sepsis in preterm neonates. J Kermanshah Univ Med Sci. 2011; 15(5):333-7.
5. Zar HJ, Ferkol TW. The global burden of respiratory disease-impact on child health. Pediatr Pulmonol. 2014; 49(5):430-4.
6. Lafond KE, Nair H, Rasooly MH, Valente F, Booy R, Rahman M, et al. Global role and burden of influenza in pediatric respiratory hospitalizations, 1982-2012: a systematic analysis. PLoS Med. 2016; 13(3): e1001977.
 7. PLOS Medicine Staff. Correction: global role and burden of influenza in pediatric respiratory hospitalizations, 1982-2012: a systematic analysis. PLoS Med. 2016; 13(6):e1002060.
8. Zar H, Jeena P, Argent A, Gie R, Madhi S. Diagnosis and management of community-acquired pneumonia in childhood-South African Thoracic Society Guidelines. S Afr Med J. 2008; 95(12 Pt 2):977-81.
 9. Scott JA, Brooks WA, Peiris JM, Holtzman D, Mulholland EK. Pneumonia research to reduce childhood mortality in the developing world. J Clin Invest. 2008; 118(4):1291-300.
 10. Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bull World Health Organ. 2008; 86: 408-16B.
 11. Gladstone IM, Ehrenkranz RA, Edberg SC, Baltimore RS. A ten-year review of neonatal sepsis and comparison with the previous fifty-year experience. Pediatr Infect Dis J. 1990; 9(11):819-25.
 12. Shah J, Jefferies AL, Yoon EW, Lee SK, Shah PS. Risk factors and outcomes of late-onset bacterial sepsis in preterm neonates born at < 32 weeks' gestation. Am J Perinatol. 2015; 32(7):675-82.
 13. Melvan JN, Bagby GJ, Welsh DA, Nelson S, Zhang P. Neonatal sepsis and neutrophil insufficiencies. Int Rev Immunol. 2010; 29(3):315-48.
 14. Watson RS, Carcillo JA, Linde-Zwirble WT, Clermont G, Lidicker J, Angus DC. The epidemiology of severe sepsis in children in the United States. Am J Respir Crit Care Med. 2003; 167(5):695-701.
 15. Aurangzeb B, Hameed A. Neonatal sepsis in hospital- born babies: bacterial isolates and antibiotic susceptibility patterns. J Coll Physicians Surg Pak. 2003; 13(11):629-32.
 16. Abdel-Fattah MM. Surveillance of nosocomial infections at a Saudi Arabian military hospital for a one-year period. Ger Med Sci. 2005; 3:Doc06.
 17. Perlman SE, Saiman L, Larson EL. Risk factors for late- onset health care-associated bloodstream infections in patients in neonatal intensive care units. Am J Infect Control. 2007; 35(3):177-82.
 18. Foglia E, Meier MD, Elward A. Ventilator-associated pneumonia in neonatal and pediatric intensive care unit patients. Clin Microbiol Rev. 2007; 20(3):409-25.
 19. Ghazvini K, Rashed T, Boskabadi H, Yazdan Panah M, Khakzadan F, Safaee H, et al. Neonatal intensive care unit nosocomial bacterial infections. Tehran Univ Med J. 2008; 66(5):349-54.
 20. Darvishpour A, Hashemian H, Faal E, Fasihi M. Survey of nosocomial infection and accompanied factors in neonatal intensive care unit. J Guilan Univ Med Sci. 2010; 19(73):37-45.
21. Gaynes RP, Edwards JR, Jarvis WR, Culver DH, Tolson JS, Martone WJ, et al. Nosocomial infections among neonates in high-risk nurseries in the United States. Pediatrics. 1996; 98(3 Pt 1):357-61.
22. Barak M, Mamishi S, Siadati SA, Salamati P, Khotaii G, Mirzarahimi M. Risk factors and bacterial etiologies of nosocomial infections in NICU and PICU Wards of children’s medical center and bahrami hospitals during 2008-2009. J Ardabil Univ Med Sci. 2011; 11(2):113-20.
 23. Kim SD, McDonald LC, Jarvis WR, McAllister SK, Jerris R, Carson LA, et al. Determining the significance of coagulase-negative staphylococci isolated from blood cultures at a community hospital a role for species and strain identification. Infect Control Hosp Epidemiol. 2000; 21(3):213-7. 24. Yogaraj JS, Elward AM, Fraser VJ. Rate, risk factors, and outcomes of nosocomial primary bloodstream infection in pediatric intensive care unit patients. Pediatrics. 2002; 110(3):481-5.
25. Hoseini MB, Abdinia B, Rezaee MA, Oskouie SA. The study of nosocomial infections in neonatal intensive care unit: a prospective study in northwest Iran. Int J Pediatr. 2014; 2(3):25-33.
26. Salamati P, Rahbarimanesh AA, Yunesian M, Naseri M. Neonatal nosocomial infections in Bahrami Children Hospital. Indian J Pediatr. 2006; 73(3):197-200.
27. Galanakis E, Krallis N, Levidiotou S, Hotoura E, Andronikou S. Neonatal bacteraemia: a population- based study. Scand J Infect Dis. 2002; 34(8):598-601.
Iranian Journal of Neonatology
Volume 10, Issue 3
September 2019
Pages 1-6

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