Korean J Pediatr.  2006 Dec;49(12):1287-1295. 10.3345/kjp.2006.49.12.1287.

Clinical characteristics and risk factors for staphylococcal infections in neonatal intensive care unit

• Chung MK
• Choi JH
• Chang JK
• Chung SH
• Bae CW
• Cha SH

• KMID: 2278501
• DOI: http://doi.org/10.3345/kjp.2006.49.12.1287

Abstract

PURPOSE: The importance of staphylococcal infections in NICU has been emphasized in terms of increased resistant strains and increased incidence of morbidity and mortality. In this study, we inrestignted the clinical characteristics and risk factors for staphylococcal infections, and looked into sensitivity trends of antibiotics in the era of a high rate of methicillin-resistant staphylococcus aureus (MRSA) in our society.
METHODS
This study included 240 neonates with positive blood, urine and other sites cultures for staphylococci who were admitted to NICU of Hanil General Hospital and Kyunghee University Hospital from January 2000 to December 2004. The analyses included clinical characteristics of staphylococcal infections and the relationship of incidence rate among various factors, including invasive procedures.
RESULTS
For 5 years, 3,593 patients were hospitalized in the NICU and 7,481 specimens were cultured from blood, urine, and other sites. During the study period, staphylococci were isolated from 240 patients, of whom 88 patients had MRSA, 41 patients methcillin sensitive staphylococcus aureus (MSSA), 63 patients S. epidermidis, 48 patients coagulase-negative staphylococcus (CNS) except S. epidermidis infections. The risk factors associated with staphylococcal infections were less than 37 weeks of gestational age, less than 7 on a 5 minutes Apgar score, receiving TPN, applied mechanical ventilation, use of central venous catheters and other tubes. The sensitivity to vancomycin was 100 percent. A relatively high sensitivity against teicoplanin, trimethoprim-sulfamethoxazole, chloramphenicol, clindamycin and low sensitivity against gentamicin and erythromycin were shown.
CONCLUSION
To reduce staphylococcal infections in NICU, we need to monitor and manage premature neonates from the beginning of the birth process and to avoid as many invasive procedures as possible in NICU. Considering MRSA, control of preceding factors and early use of appropriate antibiotics is expected to reduce the morbidity and mortality caused by MRSA infections.

Keyword

Staphylococcus; Neonates; Clinical characteristics; Risk factor

MeSH Terms

Anti-Bacterial Agents
Apgar Score
Central Venous Catheters
Chloramphenicol
Clindamycin
Erythromycin
Gentamicins
Gestational Age
Hospitals, General
Humans
Incidence
Infant, Newborn
Intensive Care, Neonatal*
Methicillin-Resistant Staphylococcus aureus
Mortality
Parturition
Respiration, Artificial
Risk Factors*
Staphylococcal Infections*
Staphylococcus
Staphylococcus aureus
Teicoplanin
Trimethoprim, Sulfamethoxazole Drug Combination
Vancomycin
Anti-Bacterial Agents
Chloramphenicol
Clindamycin
Erythromycin
Gentamicins
Teicoplanin
Vancomycin