Multi-resistant viridans streptococcal pneumonia and sepsis in the ventilated newborn.
Mechanical ventilation increases the frequency of nosocomial infections. This study describes the frequency of multi-resistant viridans streptococcal colonisation, the clinical course of nosocomial sepsis and ventilator-associated pneumonia in mechanically ventilated neonates in the neonatal intensive care unit of Ankara University Hospital. Seventy-nine ventilated newborns were enrolled. Broncho-alveolar lavage culture and blood cultures were positive in 44 (56%) and 17 (22%) patients, respectively. The most predominant micro-organisms in broncho-alveolar lavage cultures were multi-resistant viridans streptococci (29, 66%). Viridans streptococci were also one of the predominant organisms in blood cultures (5/17, 29%). In 29 patients with broncho-alveolar lavage positive for viridans streptococci, nine (31%) had colonisation, 15 (52%) had ventilator-associated pneumonia and five (17%) had sepsis owing to viridans streptococcus. Ventilator-associated pneumonia was encountered in 52/1000 ventilation days. Mortality was caused by infection in three (10%) of them. Mechanically ventilated neonates in our neonatal intensive care unit had a high rate of both multi-resistant viridans streptococcus airway colonisation and subsequent ventilator-associated pneumonia and sepsis.
Günlemez
Ayla
A
Division of Neonatology, Ankara University School of Medicine, Ankara, Turkey. agunlemez@hotmail.com
Atasay
Begüm
B
Güriz
Haluk
H
Aysev
Derya
D
Arsan
Saadet
S
D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D003428:Cross Infection / Q000382:microbiology / Q000635:transmission*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D008826:Microbial Sensitivity Tests; D012121:Respiration, Artificial / Q000009:adverse effects*; D013290:Streptococcal Infections / Q000382:microbiology / Q000635:transmission*; D014421:Turkey; D034363:Viridans Streptococci / Q000187:drug effects* / Q000302:isolation & purification