Articles

Associated Factors and Common Pathogens of Positive Cultures in Infants With Definitive Septicemia Admitted to NICU

Abstract

 Immune system immaturity in newborns exposes them to infections, among which bloodstream infection is of great importance due to high mortality and morbidity and treatment costs. The aim of the present study was to evaluate common pathogens in blood culture positive cases and its determinants. This study was conducted in two phases, including a cross-sectional phase to collect the cases of definitive septicemia and a case-control phase on neonates admitted to the Neonatal Intensive Care Unit of Vali-e-Asr Hospital with clinical suspicion of sepsis during 2015-2019. The eligible cases were selected based on the study criteria. After extracting descriptive statistics, to evaluate causal relationships, culture-positive and culture negative cases were compared in terms of neonatal disease in the second phase. SPSS-22 was used for data analysis. The most common bacterial families were Staphylococcus (34.30%), Acinetobacter (10.46%), and Klebsiella (7.55%), among which coagulase negative Staphylococcus was the most common organism (13.08%). The most common antibiotics prescribed were ampicillin (75.1%), amikacin (58%), and gentamycin (44.8%). Factors that had a significant association were the occurrence of septicemia were gestational hypertension, premature rupture of membranes, conjunctivitis, TORCH infections, and low gestational age. The results of this study will be helpful in anticipation and management of neonatal septicemia through shedding light on some determinants of common blood culture pathogens like infections and obstetric complications in NICU admitted neonates.  

1. Labi A-K, Obeng-Nkrumah N, Bjerrum S, Enweronu-Laryea C, Newman MJ. Neonatal bloodstream infections in a Ghanaian Tertiary Hospital: Are the current antibiotic recommendations adequate? BMC Infectious Diseases. 2016;16(1):1-12.
2. Chen I-L, Chiu N-C, Chi H, Hsu C-H, Chang J-H, Huang DT-N, et al. Changing of bloodstream infections in a medical center neonatal intensive care unit. Journal of Microbiology, Immunology and Infection. 2017;50(4):514-20.
3. Nikkhoo B, Lahurpur F, Delpisheh A, Rasouli MA, Afkhamzadeh A. Neonatal blood stream infections in tertiary referral hospitals in Kurdistan, Iran. Italian journal of pediatrics. 2015;41(1):1-4.
4. Wynn JL, Wong HR, Shanley TP, Bizzarro MJ, Saiman L, Polin RA. Time for a neonatal–specific consensus definition for sepsis. Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. 2014;15(6):523.
5. Stoll BJ, Hansen NI, Sánchez PJ, Faix RG, Poindexter BB, Van Meurs KP, et al. Early onset neonatal sepsis: the burden of group B Streptococcal and E. coli disease continues. Pediatrics. 2011;127(5):817-26.
6. Bizzarro MJ, Jiang Y, Hussain N, Gruen JR, Bhandari V, Zhang H. The impact of environmental and genetic factors on neonatal late-onset sepsis. The Journal of pediatrics. 2011;158(2):234-8. e1.
7. Verani JR, McGee L, Schrag SJ. Prevention of perinatal group B streptococcal disease: revised guidelines from CDC, 2010. 2010.
8. Lee B, Newland JG, Jhaveri R. Reductions in neonatal listeriosis:“Collateral benefit” of Group B streptococcal prophylaxis? Journal of Infection. 2016;72(3):317-23.
9. Dong Y, Speer CP. The role of Staphylococcus epidermidis in neonatal sepsis: guarding angel or pathogenic devil? International Journal of Medical Microbiology. 2014;304(5-6):513-20.
10. Jean-Baptiste N, Benjamin DK, Cohen-Wolkowiez M, Fowler VG, Laughon M, Clark RH, et al. Coagulase-negative staphylococcal infections in the neonatal intensive care unit. Infection Control & Hospital Epidemiology. 2011;32(7):679-86.
11. Marchant EA, Boyce GK, Sadarangani M, Lavoie PM. Neonatal sepsis due to coagulase-negative staphylococci. Clinical and Developmental Immunology. 2013;2013.
12. Cetinkaya M, Cekmez F, Buyukkale G, Erener-Ercan T, Demir F, Tunc T, et al. Lower vitamin D levels are associated with increased risk of early-onset neonatal sepsis in term infants. Journal of perinatology. 2015;35(1):39-45.
13. Salimnia H, Fairfax MR, Lephart PR, Schreckenberger P, DesJarlais SM, Johnson JK, et al. Evaluation of the FilmArray blood culture identification panel: results of a multicenter controlled trial. Journal of clinical microbiology. 2016;54(3):687-98.
14. Mitt P, Metsvaht T, Adamson V, Telling K, Naaber P, Lutsar I, et al. Five-year prospective surveillance of nosocomial bloodstream infections in an Estonian paediatric intensive care unit. Journal of Hospital Infection. 2014;86(2):95-9.
15. Worth L, Daley A, Spelman T, Bull A, Brett J, Richards M. Central and peripheral line-associated bloodstream infections in Australian neonatal and paediatric intensive care units: findings from a comprehensive Victorian surveillance network, 2008–2016. Journal of Hospital Infection. 2018;99(1):55-61.
16. Crivaro V, Bogdanović L, Bagattini M, Iula VD, Catania M, Raimondi F, et al. Surveillance of healthcare-associated infections in a neonatal intensive care unit in Italy during 2006–2010. BMC infectious diseases. 2015;15(1):1-8.
17. Escalante MJ, Ceriani-Cernadas JM, D'Apremont I, Bancalari A, Webb V, Genes L, et al. Late Onset Sepsis in Very Low Birth Weight Infants in the South American NEOCOSUR Network. The Pediatric infectious disease journal. 2018;37(10):1022-7.
18. Ozkan H, Cetinkaya M, Koksal N, Celebi S, Hacımustafaoglu M. Culture-proven neonatal sepsis in preterm infants in a neonatal intensive care unit over a 7 year period: coagulase-negative Staphylococcus as the predominant pathogen. Pediatrics international : official journal of the Japan Pediatric Society. 2014;56(1):60-6.
19. Cailes B, Kortsalioudaki C, Buttery J, Pattnayak S, Greenough A, Matthes J, et al. Epidemiology of UK neonatal infections: the neonIN infection surveillance network. Archives of Disease in Childhood-Fetal and Neonatal Edition. 2018;103(6):F547-F53.
20. Gandra S, Ranga SK, Hendrixson DT, Nayakanti RR, Newland JG, Alvarez-Uria G, et al. Association of Intrapartum Risk Factors and Infant Clinical Indicators with Culture Confirmed Early Onset Neonatal Sepsis in a Secondary Care Rural Hospital in India. Journal of tropical pediatrics. 2021;67(3).
21. Rafi MA, Miah MMZ, Wadood MA, Hossain MG. Risk factors and etiology of neonatal sepsis after hospital delivery: A case-control study in a tertiary care hospital of Rajshahi, Bangladesh. PloS one. 2020;15(11):e0242275.
Files
IssueVol 61 No 6 (2023) QRcode
SectionArticles
DOI https://doi.org/10.18502/acta.v61i6.13836
Keywords
Common pathogens Neonate Septicemia
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Shariat M, Baghban Youssefkhani A, Dalili H, Hajinasab N, Farrokhzad N, Nozarian Z, Enayati Yasamin S, Raji F. Associated Factors and Common Pathogens of Positive Cultures in Infants With Definitive Septicemia Admitted to NICU. Acta Med Iran. 2023;61(6):355-360.