الفهرس Only 14 pages are availabe for public view
 |  | from | 192 |  |  |
| | | from | 192 | | |
Abstract
Nosocomial infections represent a major problem in NICU. Neonates admitted in the NICU show higher rates of morbidity and mortality.
Our study was conducted over a period of 3 months from 1/11/2007 to 31/1/2008.
In the present study we tried to study and compare epidemiology of NI in two NICUs; one receiving inborn neonates and the other receiving outborn neonates.
The study included identification of NI rates and risk factors in both units, identification of the most common organisms causing NI, the appropriate antibiotics to which organisms were sensitive and tracing the sources of NI in these NICUs.
Also evaluation of infection control measures in both NICUs was done for future planning of preventive measures.
The present study was conducted on 43 neonates in inborn unit and 42 neonates in outborn unit (after exclusion of neonates admitted for less than 5 days and neonates with initial negative blood culture and clinical picture suggestive of sepsis).
Also the study included medical staff in both NICUs and the environment and instruments used in the care of the neonates in an attempt to trace the source of infection.
Investigations done on admission to neonates included CBC, CRP and blood cultures in addition to swabs from different sites of the neonates.
5 days later, CBC, CRP and blood cultures were repeated in addition to swabs from other sites of the neonates taken in special situations according to the cases.
Swabs were taken from nose, throat and hands of personnel and from NICU environments and instruments in both units.
Sensitivity for antibiotics was done for all cultures. Evaluation of infection control measures was done in both units.
The study has shown than:
• The NI rate in outborn unit was (66.7%) that was higher than inborn unit (53.5%).
• The most common encountered organism in NI was Klebsiella in both units followed by Candida, MRSA and S. aureus.
• Groins were the most common colonized sites in neonates in both units.
• The prevalent organism which colonized different sites of neonates in both units was S. aureus.
• The most common organisms colonized medical staff and isolated from NICU environment and instruments in both units were S.aureus and Klebsiella.
• The risk factors for NI in both units were prematurity, LBW, mechanical ventilation, TPN, vascular line and surgical interventions. In addition, colonization of NICU staff, environment and instruments.
• S. aureus was 100% sensitive to Vancomycin in both units, followed by amikacin and tazocin.
• Klebsiella was most frequantly sensitive to amikacin and tazocin in both units.
• There was increased incidence of multidrug resistant organisms due to abuse of empirical antibiotics in both units.