Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-19T09:29:45.492Z Has data issue: false hasContentIssue false
  • English
  • Français

Serious infection in a neonatal intensive care unit: A two-year survey

Published online by Cambridge University Press:  19 October 2009

O. J. Hensey ,
C. A. Hart  and
R. W. I. Cooke
O. J. Hensey
Affiliation:
Regional Neonatal Intensive Care Unit, Liverpool Maternity Hospital, Liverpool
C. A. Hart
Affiliation:
Department of Medical Microbiology, University of Liverpool
R. W. I. Cooke
Affiliation:
Regional Neonatal Intensive Care Unit, Liverpool Maternity Hospital, Liverpool
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Over a two-year period 160 episodes of serious infection occurred in 139 infants admitted to a regional neonatal intensive-care unit. Eighty-seven (26%) of very low birth weight (VLBW) neonates and 52 (8%) of infants of birth weight > 1500 g were infected. The majority (84%) had bactcraemia alone. Though the clinical features of infection were not distinctive, in 94% of episodes the peripheral white blood cell or band counts were abnormal. Thirty-three (21%) of the infections occurred in infants under 48 h old and 15 of these followed prolonged rupture of membranes (>48h). All of the infections due to group B streptococci (5), Streptococcus viridans (2) and Haemophilus influenzae (3) occurred in this group. Coagulase-negativc staphylococci (CONS) accounted for 49% of the infections and there was a marked increase in incidence of such infections during the survey. Infections with CONS were not necessarily associated with parenteral nutrition, the presence of intra-arterial catheters or mechanical ventilation but the rise in incidence was coincident with change in skin disinfectant usage and the general use of a third-generation cephalosporin to which the CONS were resistant.

Although VLBW infants with meningitis were more likely to die than those of higher birthweight, the risk for those with bacteriacmia was the same in both groups. Infants with CONS sepsis were less likely to die than those with infections due to Gram-negative bacteria and the time from onset of infection to death was significantly longer for the former.

Type
Research Article
Information
Journal of Hygiene , Volume 95 , Issue 2 , October 1985 , pp. 289 - 297
Copyright
Copyright © Cambridge University Press 1985

References

REFERENCES

Battisti, O., Mitchison, R. & Davies, P. A. (1981). Changing blood culture isolates in a referral neonatal intensive care unit. Archives of Diseases in Childhood 56, 775–778.CrossRefGoogle Scholar
Callaghan, R. P., Cohen, S. J. & Stewart, G. T. (1901). Septicaemia due to colonization of Spitz-Holter valves by staphylococci. British Medical Journal i, 860–863.Google Scholar
Chan, M. K., Chuah, P., Raferty, M. S., Baillod, R. A., Sweny, P., Varghese, Z. & Moorhead, J. F. (1981). Three years of continuous ambulatory peritoneal dialysis. Lancet i, 1408–1412.Google Scholar
Davies, A. J., Ward-Platt, M., Kirk, R., Marshall, R., Speidel, B. D. & Reeves, D. S. (1984). Is coagulase-negative staphylococcal bacteraemia in neonates a consequence of mechanical ventilation? Journal of Hospital Infection 5, 260–269.CrossRefGoogle ScholarPubMed
Douglas, J. W. B. & Gear, R. (1977). Children of low birthweight in the 1946 national cohort: behaviour and educational achievement in adolescence. Archives of Diseases in Childhood 51, 820–827.CrossRefGoogle Scholar
Editorial (1981). Neonatal infection with Group B streptococci. Lancet ii, 181–182.Google Scholar
Fleer, A., Senders, R. C., Visser, M. R., Bijlmer, R. P., Gerards, L. J., Kraaijeveld, C. A. & Verhoef, J. (1983). Septicaemia duo to coagulaso negative staphylococci in a neonatal intensive care unit: clinical and bacteriological features and contaminated parenteral fluids as a source of sepsis. Pedialric Infectious Diseases 2, 426–431.CrossRefGoogle Scholar
Freedman, R. M., Ingram, D. L., Gross, I., Ehrenkranz, R. A., Warkshaw, J. B. & Baltimore, R. S. (1981). A half century of neonatal sepsis at Yale: 1028 to 1078. American Journal of Diseases of Children 135, 140–144.CrossRefGoogle Scholar
Goldman, D. A. & Maki, D. G. (1973). Infection control in total parenteral nutrition. Journal of the American Medical Association 223, 1300–1304.Google Scholar
Hensey, O. J., Hart, C. A. & Cooke, R. W. I. (1984). Candida albicans skin abscesses. Archives of Diseases in Childhood 59, 470–480.CrossRefGoogle ScholarPubMed
Hoookamp-Korstanje, J. A. A., Cats, B., Sendeks, R. C. & van Ertbruooen, I. (1982). Analysis of bacterial infections in a neonatal intensive euro unit. Journal of Hospital Infection 3, 275–284.CrossRefGoogle Scholar
Klein, J. O. & Marcy, S. M. (1976). Bacterial infections. In Infectious Diseases of the Fetus and Newborn (ed. Remington, J. S. and Klein, J. O.), pp. 747–796. Philadelphia: Saundere.Google Scholar
Manroe, B. L., Weinberg, A. G., Rosenfeld, C. R. & Browne, R. (1979). The neonatal blood count in health and disease. I. Reference values for neutrophilic cells. Journal of Pediatrics 95, 80–88.CrossRefGoogle ScholarPubMed
Meers, P. D., Ayliffe, G. A. J., Emmerson, A. M., Leigh, D. A., Mayon-White, R. T., Mackintosh, C. A. & Strange, J. L. (1981). Report on the national survey of infection in hospitals. Journal of Hospital Infection 2, Suppl. 1.Google Scholar
Morgan, M. E. I. & Hart, C. A. (1982). Acinetobacter meningitis: acquired infection in a neonatal intensive care unit. Archives of Diseases in Childhood 57, 557–558.CrossRefGoogle Scholar
Morgan, M. E. I., Hart, C. A. & Cooke, R. W. I. (1984). Klebsiella infection in a neonatal intensive care unit: Role of bacteriological surveillance. Journal of Hospital Infection 5, 377–385.CrossRefGoogle Scholar
Oto, A. (1982). Major bacterial infection in a referral intensive care unit. Journal of Infection 5, 117–126.CrossRefGoogle Scholar
Sieoel, J. D. & McCracken, G. H. (1981). Sepsis neonatorum. New England Journal of Medicine 304, 642–647.Google Scholar
Starte, D. R., Jones, R. A. K., Hall, M. A. & Harvey, D. R. (1980). Survival of pre-term babies. Lancet ii, 639–640.CrossRefGoogle Scholar
Wade, J. C., Schimpff, S. C., Newman, K. A. & Wiernick, P. H. (1982). Staphylococcus epidermidis: an increasing cause of infection in patients with granulocytopaenia. Annals of Internal Medicine 97, 503–508.CrossRefGoogle Scholar