Pathogen distribution and risk factors of nosocomial infections in neonates in the neonatal intensive care unit

Abstract:

OBJECTIVE: To study the pathogen distribution and risk factors of nosocomial infections in neonates in the neonatal intensive care units (NICU). METHODS: The clinical data of 145 neonates with nosocomial infection in the NICU were retrospectively reviewed. RESULTS: Of the 145 neonates, 41 (28.3%) were infected with Klebsiella pneumoniae, 39 (26.9%) with Escherichia coli, 10 (6.9%) with Staphylococcus epidermidis, and 55 (37.9%) with other pathogens. Logistic regression analysis showed that a gestational age of ≤32 weeks (OR=5.57), birth weigh of <1500 g (OR=6.95), hospitalization time (OR=1.23), mechanical ventilation (OR=14.12) and parenteral nutrition (OR=3.01) were major risk factors for nosocomial infections caused by Klebsiella pneumoniae. The five factors were also main risk factors for nosocomial infection caused by Escherichia coli, with the OR of 3.42, 6.73, 9.96, 0.55 and 2.13 respectively. Klebsiella pneumoniae and Escherichia coli were highly resistant to β-lactam antibiotics but were relatively sensitive to levofloxacin and meropenem. CONCLUSIONS: Klebsiella pneumoniae, Escherichia coli and Staphylococcus epidermidis are major pathogens of nosocomial infections in neonates in the NICU and they are resistant to β-lactam antibiotics. Mechanical ventilation and hospitalization time are the most important risk factors for nosocomial infections caused by Klebsiella pneumoniae and Escherichia coli respectively.