F. Nur ÇAKMAK, Gülnar UYSAL, Sevim ÜNAL, Hülya OSKOVİ, Figen GÜNİNDİ, A. Esin KİBAR, Ebru ARHAN

Yenidoğan Yoğun Bakım Ünitesindeki Nozokomiyal Pseudomonas İnfeksiyonlu Olgularımız

Amaç: Yenidoğan bebeklerin bakım ve tedavisindeki gelişmeler yaşam sürelerini artırmıştır. Düşük doğum ağırlıklı yenidoğan bebeklerin yaşam sürelerinin uzamasına paralel olarak nozokomiyal enfeksiyon sıklığıda artmıştır.Gereç ve Yöntem: Bu çalışmada, Eylül 2003-Ağustos 2004 tarihleri arasında hastanemiz yenidoğan yoğun bakım ünitesinde nozokomiyal Pseudomonas infeksiyonu gelişen olgular ve bu mikroorganizmaların antibiyotik duyarlılıkları retrospektif olarak değerlendirildi.Bulgular: Bu dönemde yatırılan 978 hastanın 17’sin den alınan 146 kültürden 38’inde Pseudomonas spp üredi. Olguların postnatal yaş ortalaması 45.0±83.7 saatti. Onbir olgu (%64.7) preterm, 6’sı (%35.3) term bebekti. Ortalama gestasyon yaşı 33.2±4.9(26-37) hafta olarak bulundu. Ortalama doğum ağırlığı 1807.4±826.9 (1345-3200 gr) gramdı. Hastanede kalış süresi ortalama 43±31.5 gün idi. Üreme öncesi tüm vakalar antibiyotik almıştı. Pseudomonas suşlarının en fazla imipenem (%94) ve siprofloksasine (%86) duyarlı olduğu saptandı. Kültürlerin %82’si amikasin, %80’i piperasillin, %50’si netilmisine duyarlıydı.Sonuç: Uygun antibiyotik seçimi ve hijyen önlemleri ile nozokomiyal infeksiyonlarda başarılı olunacağı düşünüldü.

Anahtar Kelimeler:

Yenidoğan, nozokomiyalinfeksiyon, Pseudomonas infeksiyonları

NOSOCOMIAL PSEUDOMONAS INFECTIONS IN OUR NEONATAL INTENSIVE CARE UNIT

Aim: Improvement in the care and treatment of neonates has contributed to increased survival. In the last few years, nosocomial infection frequency has risen up owing to the increased survival rates in the neonates. Material and Method: In this study, we retrospectively assessed the prevalence of Pseudomonas infection and antibiotic sensitivity of these microorganism in our neonatal intensive care unit between September 2003-August 2004. Results: A total of 978 neonates were hospitalized during this period. 146 cultures were collected from 17 patients and Pseudomonas was isolated in 38 of these cultures. Of these 17 patients, 11(64.7%) were premature and 6(35.3%) were mature.The average birth weight was 1807.47±826.9 g(1345-3200 gr), average gestational age was 33.2±4.9 weeks and average postnatal age was 45.05±83.7 hours. Mean hospitalization time was 43±31.5 days. Antibiotics were administered to all cases before Pseudomonas isolation. The best antimicrobial sensitivity was observed with Imıpenem (94%) and Ciprofloxacin (86%) which were the most effective antibiotics for Pseudomonas infections. Of this 38 cultures, 82% were sensitive to amicasin, 80% to piperasilin, 50% to netilmycin. Conclusion: Appropiate antibiotic selection and improvements in hygiene are required to reduce the incidence of nosocomial infections in neonatal intensive care unit

Keywords:

Neonates, nosocomial infection, pseudomonas infection,

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