| Retrospective 3-year Clinical Study of Enterobacter Bacteremia in Neonatal Intensive Care Unit |
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Kwang Ok Chung, Chun Hyuk Chang, Sung Min Cho, Dong Seok Lee, Doo Kwun Kim, Sung Min Choi |
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Department of Pediatrics, College of Medicine, Dongguk University, Kyongju, Korea |
| 신생아 집중 치료실에서 발생한 Enterobacter 균혈증에 대한 연구 |
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정광옥, 장준혁, 조성민, 이동석, 김두권, 최성민 |
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동국대학교 의과대학 소아과학교실 |
Correspondence:
Kwang Ok Chung, Email: 1
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| Abstract |
Purpose
: Enterobacter is one of the important organisms in neonatal intensive care unit. We
reviewed the clinical characteristics, underlying diseases, invasive procedures during admission,
mortality and antibiotic sensitivity of Enterobacter infection in NICU.
Methods
: We retrospectively reviewed 21 neonatal patients whose blood cultures yielded
Enterobacter between June 1994 and June 1997 at Dongguk University Hospital.
Results
: Blood cultures were positive in 62 from 2,025 neonates and 21 was Enterobacter. The
clinical spectrums were diverse such as sepsis(85%), pneumonia, disseminated intravascular coagulopathy
and necrotizing enterocolitis. The underlying conditions upon admission were composed of
prematurity(38%), hyaline membrane disease(38%), jaundice, sepsis and pneumonia. The procedures
used during admission were endotracheal intubation(57%), mechanical ventilation(57%), umbilical
vessel catheterization, gastric tube inserition, total parenteral nutrition and exchange transfusion.
The antibiotic sensitivity was as follows : ampicillin(0%), ceftriaxone(0%), amikacin(55%), gentamicin(
85%), ciprofloxacin(100%), imipenem(100%). Overall mortality was 26.5%. Mortality was significantly
high in cases of leukopenia(P ≤0.01), thrombocytopenia(P ≤0.01) and use of inappropriate
antibiotics(P ≤0.01).
Conclusion
: Enterobacter is an important organism in the cause of nosocomial infection in NICU
and has a high rate of mortality. Enterobacter infection was associated with prolonged
hospitalization, invasive procedures and preceding antibiotics. Commonly used antibiotics such as
penicillin and cephalosporin would be inappropriate for the treatment of Enterobacter infection. We
consider the use of gentamicin or imipenem to be far more effective in the initial therapy of
Enterobacter infection. |
| Key Words:
Enterobacter bacteremia, Nosocomial infection, Newborn, Neonatal sepsis |
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