Füsun OKAN, EMİNE ASUMAN ÇOBAN, Zeynep İNCE, Gülay CAN

Yenidoğan döneminde pnömoni

Amaç: Solunum güçlüğü nedeniyle yatırılan yenidoğanlarda pnömoni sıklığını, klinik özelliklerini ve sonuçlarını araştırmak. Yöntem: Neonatoloji bilim dalına 5 yıllık sürede solunum güçlüğü nedeniyle sevk edilerek yatırılan bebeklerin kayıtları retrospektif olarak incelendi. Bulgular: Solunum güçlüğü olan 230 yenidoğanın 64'ü (% 27.8) neonatal pnömoni tanısı aldı. Bebeklerin 115'i (% 50) term, 110'u preterm (47.8), 6'sı postterm (% 2.2) doğmuştu. Term bebeklerde en sık solunum sıkıntısı nedeni pnömoni (% 43.5), preterm bebeklerde respiratuvar distres sendromu (% 23.4) bulundu. Bebeklerin ortalama gebelik yaşı (±standart sapma) 38.2±2.4 hafta, doğum ağırlığı 2975±173 g hastaneye yatırılma zamanı 20.5±8.0 gündü. Pnömonili vakaların 29'unda (% 45) etken belirlendi: 20'sinde (% 31.2) nazofarengeal aspiratta Respiratuar sinsisyal virus antijeni, 8'inde (% 12.5) hemokültürde bakteri, 1'inde (% 1.5) Mycoplasma pneumonia IgM (+) saptandı. Hemokültürde üretilen bakterilerin 5'i trakeal aspirat kültüründe de izole edildi. Hastanede yatış süresi 9.3±7.7 gündü. Mekanik ventilasyon 11 (% 17) bebeğe uygulandı. Pnömonisi olan 2 pretem bebek (% 3.1) kaybedildi. Sonuç: Solunum sıkıntısı nedeniyle yatırılma nedenleri arasında pnömoni birinci sıradaydı. Mortalitenin düşük olmasına karşın pnömonisi olan bebeklerin % 17'sine mekanik ventilasyon uygulanması, neonatal pnömonilerin yenidoğan döneminde ciddi bir morbidite nedeni olduğunu göstermektedir.

Anahtar Kelimeler:

Süt çocuğu, yenidoğan, Geriyedönük çalışma, Solunum güçlüğü sendromu, yenidoğan, Pnömoni

Pneumonia in neonates

Aim: To find causes of respiratory distress in neonates and evaluate the incidence, etiology and outcome of neonatal pneumonia. Methods: All babies referred and admitted to the neonatal unit with respiratory distress during 5 years period were retrospectively studied. Results: There were 230 newborn with respiratory distress, 64 (27.8 %) of them had pneumonia. Of the babies 115 (50 %) were full-term, 110 (47.8 %) were preterm, and 6 (2.2 %) were post-term. Respiratory disstress syndrome was found to be the most common cause of respiratory distress in preterm infants, whereas pneumonia was the most common cause in full-term babies. The mean gestational age (±standart deviation) was 38.2±2.7 weeks, birth weight was 2975±173 g, and the mean admission time was 20.5±8.0 days. Altogether, a bacterial or viral etiology of neonatal pneumonia could be established in 29 cases (45 %). Micro-organisms were cultured from blood in 8 babies (12.5 %) and same pathogen identified from tracheal aspirates in 5. In 20 babies (31.2 %) RSV antigen was detected in nasofarengeal secretions and in one baby (1.5 %) Mycoplasma pneumonia antibody was detected in serum. Two preterm babies (3.1 %) with pneumonia were died. Conclusion: Pneumonia was the most common cause of respiratory distress in neonates. Although mortality was found to be low, requirement of assisted ventilation in 17 % of the babies with pneumonia indicates the severity and high morbidity.

Keywords:

Infant, Newborn, Retrospective Studies, Respiratory Distress Syndrome, Newborn, Pneumonia,

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