Hacer YAPICIOĞLU, Ayşe ÖZKAN, Mustafa YILMAZ, Yaşar SERTDEMİR

Yenidoğan döneminde sağlık bakımı ile ilişkili enfeksiyon geçirmiş ve geniş spektrumlu antibiyotik kullanmış olmanın erken çocukluk döneminde gözlenen astma, allerjik rinit ve atopik dermatit üzerine etkisi

Amaç: Bu çalışmadaki amacımız yenidoğan döneminde sağlık bakımı ilişkili enfeksiyon (SBİE) geçiren ve geniş spektrumu antibiyotik kullanan çocuklarda astma, allerjjk rinit ve atopic dermatit sıklığını araştırmaktır. Gereç ve Yöntem: Çalışmaya Yenidoğan Yoğun Bakım Ünitesi’nde 6 yıl içinde izlenen 73 SBİE olan çocuk ile bu çocukların yenidoğan döneminde sağlıklı olan 41 kardeşi alındı. Ebeveynlere detaylı bir anket uygulandı ve çocuklardan tam kan sayımı, serum total Ig Eve spesifik IgE için kan örnekleri alındı. Bulgular: SBİE olan 73 çocuğun 32’sinde (%45.2) ventilator ilişkili pnömoni, 28’inde (%38.4) kan dolaşımı enfeksiyonu, 12’sinde (%16.4) klinik sepsis gözlenmişti. Astma SBİE grubunda belirgin daha fazla (%32.9’a karşın %4.9) iken allerjik rinit (%4.1’e karşın %2.4) ve atopik dermatit sıklığı farklı değildi (%6,8’e karşın %0). Allerjisi olmayan 85 çocuk ile allerjisi olan 29 çocuk kıyaslandığında, yenidoğan döneminde SBİE geçirmek ve antibiyotik kullanmak allerjik olma oranını 11.5 kat arttırmaktaydı. Sonuç: SBİE grubunda astma daha sık gözlenmiş olup, yenidoğan döneminde SBİE geçirmek ve geniş spektrumlu antibiyotik kullanmak erken çocukluk döneminde allerji riskini arttırmaktadır.

Anahtar Kelimeler:

Antibiyotik, allerjik hastalıklar, sağlık bakımı ilişkili enfeksiyon, yenidoğan dönemi

Effect of healthcare associated infections and broad spectrum antibiotic use in newborn period on development of asthma, allergic rhinitis and atopic dermatitis in early childhood

Purpose: The iam of this study was to investigate the effect of healthcare associated infections (HAIs) and broad spectrum antibiotic use in newborn period on asthma, allergic rhinitis and atopic dermatitis. Material and Methods: Seventy three children treated for HAIs in newborn period in Neonatal Intesive Care Unitin a 6 years period, and their 41 siblings who were healthy in newborn period were included in the study. Parents answered a detailed questionnaire, children were examined and complete blood count, serum total Ig E and specific Ig E levels were studied. Results: Ventilator associated pneumonia was observed in 32 (45.2%), blood stream infection in 28 (38.4%) and clinic sepsis in 12 (16.4%) of 73 children with HAIs. Asthma was significantly higher in HAIs group compared to sibling group (32.9% vs. 4.9), whereas there was no significant difference in allergic rhinitis (4.1% vs.2.4%) and atopic dermatitis (6.8% vs. 0%) among groups. When non-allergic 85 subjects and allergic 29 children compared, children who had been hospitalised and treated with broad-spectrum antibiotics in newborn period were almost 11.5 times as likely to have an allergic disease. Conclusion: Asthma was significantly higher in HAI group, and allergic disease risk seems to increase in children treated with broad-spectrum antibiotics for HAIs in newborn period

Keywords:

Antibiotics, allergic disease, healthcare associated infection, newborn period.,

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