Korean J Pediatr.  2004 Apr;47(4):373-379.

Clinical Characteristics and Epidemiologic Study of Infection Due to Extended Spectrum beta-Lactamase Producing Organism in a Neonatal Intensive Care Unit

• Jun NL
• Im JW
• Park HK
• Kim MN
• Kim EA
• Kim KS
• Pi SY

Abstract

PURPOSE
The extended-spectrum beta-lactamase(ESBL) producing organism have emerged to be an important pathogen in neonatal intensive care unit(NICU). This study was conducted to investigate incidence, characteristics and risk factors associated with ESBL organism among newborns in NICU.
METHODS
The subjects included 98 newborns admitted to NICU at Asan Medical Center between September 1998 to July 2002, from whom a total of 177 ESBL organisms were detected. Annual number of isolates, distribution of cultured sites, types of illness and patient profile were retrospectively reviewed and risk factors associated with the infection were identified between control group of 115 non-infected newborns.
RESULTS
Of 177 ESBL isolates, 150(84.7%) and 27(15.3%) were ESBL producing K. pneumoniae and E. coli, respectively. The annual number of isolates were 2(1.1%), 23(13.0%), 126(71.2%), 17(9.6%) and 9(5.1%) for years 1998 to 2002. The annual incidence of sepsis due to ESBL organism was 2.9%, 8.2%, 17.8%, 3.1% and 2.8% for years 1998 to 2002:Year 2000 being an outbreak. The ESBL organisms were largely found in bronchial aspirates and urine. The infected patients were younger gestational age. The mean cultivation period was at 29.1+/-2.8 days. The risk factors for infection included, in the order of frequency, total parenteral nutrition, central venous catheterization, ventilator care, respiratory distress syndrome and dexamethasone therapy.
CONCLUSION
Awareness of increasing infection due to ESBL producing organism in NICU is important not only for infection control but also placing a great limit in use of antibiotics, especially in premature infants.

Keyword

Extended-spectrum beta-lactamase(ESBL); E. coli; K. pneumoniae; Risk factors; Newborn

MeSH Terms

Anti-Bacterial Agents
beta-Lactamases*
Catheterization, Central Venous
Central Venous Catheters
Chungcheongnam-do
Dexamethasone
Epidemiologic Studies*
Gestational Age
Humans
Incidence
Infant, Newborn
Infant, Premature
Infection Control
Intensive Care, Neonatal*
Parenteral Nutrition, Total
Pneumonia
Retrospective Studies
Risk Factors
Sepsis
Ventilators, Mechanical
Anti-Bacterial Agents
Dexamethasone
beta-Lactamases