TITLE:
Retrospective Epidemiological Investigation on Nosocomial Neonatal Sepsis in Shaanxi Province (2008-2010)
AUTHORS:
Li Zhang, Qin Zhang, Heqin Li, Wenjing Wang, Wenping Song, Huirong Li, Xun Jiang, Liming Ni, Li Liu, Yaping Wang
KEYWORDS:
Incidence, Mortality, Pathogens, Nosocomial, Infection, Neonatal Sepsis
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.6 No.4,
November
3,
2016
ABSTRACT: Objective:
This study assessed the incidence, mortality, and pathogens associated with
nosocomial neonatal sepsis (NNS) in Shaanxi Province to improve the prevention
and control of NNS. Methods: Nine large neonatal departments in Shaanxi
Province participated in this retrospective epidemiological investigation of NNS
during the period of 2008-2010, using standardized protocol. The incidence,
mortality, pathogens, antibiotic sensitivity, clinical characteristics,
prognosis, and costs were analyzed. Results: Of 16,642 neonates admitted to
neonatal departments in the 9 hospitals during 2008-2010, there were 139 cases
of NNS, with incidence of 8.3% and mortality of 20.8%. The predominant
pathogens were Gram-negative bacteria, accounting for 67.6% of positive
cultures. Gram-positive bacteria accounted for 24.5% and fungal infection
accounted for 7.9%. The most common Gram-negative species were Klebsiella pneumonia (22.3%), Escherichia coli (15.1%), and Enterobacter cloacae (8.6%). The
dominant Gram-positive species identified were coagulase negative
staphylococcal species (CONS) (8.6%), followed by Staphylococcus aureus (7.9%). The recovered bacterial pathogens
demonstrated varying antibiotic resistance, but no meropenem-or-vancomycin-resistant
strains were detected. Preterm and full-term infants showed significant
difference in clinical manifestations, laboratory findings, mortality, and
cost. Conclusion: NNS in the hospitals of Shaanxi Province showed a decreasing
trend from 2008 to 2010, but the mortality did not reduce significantly. The
predominant bacteria were Gram negative, and pathogens were found to have
varying antibiotic resistance. The preterm group had higher mortality and costs
than the full-term infants. Therefore, effective measures should be taken to
control NNS, especially in preterm infants.