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Original Article
  |     |   J Korean Soc Neonatol._18_2_265_271.pdf
J Korean Soc Neonatol. November;18(2):265-271.
Published online 2011 November 25   doi: https://doi.org/10.5385/jksn.2011.18.2.265
Copyright ⓒ 2011 The Korean Society of Neonatology Neonatal Medicine
Analyses of Clinical Characteristics and Hematologic Studies of Confirmed Infants by Extended Spectrum β-lactamase Producing Escherichia coli or Klebsiella pneumonia in Neonatal Intensive Care Unit
Sungeun Lee, M.D., Minhwan Choi, M.D., Gyu Hong Shim, M.D. and Myoung Jae Chey, M.D.
Department of Pediatrics, Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Korea
Corresponding Author: Myoung Jae Chey, M.D. , Tel: +82-2-950-1625 , Fax: +82-2-951-1246 , Email: neonate@paik.ac.kr
ABSTRACT
Purpose: Extended spectrum β-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.
Keywords: Extended spectrum β-lactamase, Neonates, Neonatal intensive care unit
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