J Korean Soc Neonatol.  2011 Nov;18(2):265-271. 10.5385/jksn.2011.18.2.265.

Analyses of Clinical Characteristics and Hematologic Studies of Confirmed Infants by Extended Spectrum beta-lactamase Producing Escherichia coli or Klebsiella pneumonia in Neonatal Intensive Care Unit

• Lee S
• Choi M
• Shim GH
• Chey MJ

• KMID: 2099201
• DOI: http://doi.org/10.5385/jksn.2011.18.2.265

Abstract

PURPOSE
Extended spectrum beta-lactamase (ESBL) producing organism is an important cause of infections in the neonatal intensive care unit (NICU) since 1990s. The aim of this study is to investigate the differences of clinical characteristics and hematologic studies between neonates with ESBL-positive organism and those with ESBL-negative organism.
METHODS
The subjects included 48 neonates admitted to NICU at Inje University Sanggye Paik Hospital from January 2005 to September 2010, from whom a total of 58 Escherichia coli or Klebsiella pneumonia were detected. The data were categorized in 2 groups, neonates with ESBL-positive and ESBL-negative. We compared clinical characteristics and hematologic studies between two groups.
RESULTS
Of 48 neonates and 53 isolates, ESBL-positive were 18 neonates and 20 isolates. Both ESBL-positive and ESBL-negative isolates were largely found in urine, each with 10 and 23. Of 20 ESBL-positive isolates, 13 (65%) and 7 (35%) were ESBL producing Escherichia coli and Klebsiella pneumonia, respectively. ESBL-positive neonates were associated with low 1 and 5 minutes Apgar scores (P=0.002 and P=0.001, respectively), more uses of oxygen (56% vs. 27%; P=0.005), longer duration of oxygen uses (15.8+/-38.43 days vs. 4.3+/-12.5 days; P=0.008) and more frequent anemia (33% vs. 7%; P=0.040).
CONCLUSION
ESBL-positive neonates may have more anemia and lower Apgar score at birth. We can consider the use of cabapenem earlier if infant with previous antibiotics is confirmed to be infected with ESBL-positive organisms.

Keyword

Extended spectrum beta-lactamase; Neonates; Neonatal intensive care unit

MeSH Terms

Anemia
Anti-Bacterial Agents
Apgar Score
beta-Lactamases
Escherichia
Escherichia coli
Humans
Infant
Infant, Newborn
Intensive Care, Neonatal
Klebsiella
Oxygen
Parturition
Pneumonia
Anti-Bacterial Agents
Oxygen
beta-Lactamases