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

Korean Journal of Pediatrics 2004;47(4):373-379.
Published online April 15, 2004.
Clinical Characteristics and Epidemiologic Study of Infection Due to Extended Spectrum β-Lactamase Producing Organism in a Neonatal Intensive Care Unit
Nu-Lee Jun1, Jae-Woo Im1, Hyun-Kyung Park1, Mi-Na Kim2, Ellen Ai-Rhan Kim1, Ki-Soo Kim1, Soo-Young Pi1
1Department of Pediatrics, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
2Department of Laboratory Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
단일병원 신생아 중환자실에서 Extended Spectrum β-Lactamase 생성 균주 출현의 역학 및 임상적 특징
전누리1, 임재우1, 박현경1, 김미나2, 김애란1, 김기수1, 피수영1
1울산대학교 의과대학 서울아산병원 소아과
2울산대학교 의과대학 서울아산병원 진단검사의학과
Correspondence: 
Ellen Ai-Rhan Kim, Email: arkim@amc.seoul.kr
Abstract
Purpose
: The extended-spectrum β-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.
Key Words: Extended-spectrum β-lactamase(ESBL), E. coli, K. pneumoniae, Risk factors, Newborn


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