ABSTRACT
PURPOSE: As the neonatal intensive care advanced, the incidence of neonatal bronchopulmonary dysplasia (BPD) has increased. We conducted a multi-center investigation of the prevalence of BPD in six hospitals to investigate the epidemiology of BPD in Korea. METHODS: Retrospective reviews ware performed for survival rate, prevalence of BPD of total 4,476 newborn infants who were admitted to neonatal intensive care unit in Konkuk university hospital, Sung-Ae General hospital, Kangbuk Samsung hospital, Chung-Ang university hospital, Konyang university hospital, and Gangneung Asan hospital between June, 2005 and May, 2007. By Ogawa, BPD was defined as oxygen dependency at 28 days after birth, with respiratory distress symptoms and the change of chest x-ray finding, and classified as 6 subtypes. Classic BPD was defined as oxygen dependency at 36 weeks of postmenstrual age. RESULTS: Survival rate at 28 day after birth was 98.7%. BPD infants by Ogawa classification were 70 (1.6% of overall newborn infants), classic BPD infants were 30 (0.7%). Especially, among 237 preterm infants with birth weight less than 1,500 gram who survived to 28 days of life, 60 (25.3%) had BPD by Ogawa classification and 23 (9.7%) had classic BPD. In Ogawa classification, infants with RDS as type I and II, were 17 infants (24.3%) and 44 infants (62.9%). Home oxygen therapy was performed 8 infants (11.4%). Prevalence of retinopathy of prematurity was 35 infants (50.0%), necrotizing enterocolitis was 3 infants (4.3%), and intraventricular hemorrhage was 6 infants (8.6%). CONCLUSION: Prevalence of BPD infants was 1.6% of overall newborn, 25.3% of preterm infants with birth weight less than 1,500 gram. Among 70 BPD infants, BPD by Ogawa classification with history of RDS as type I and II were 24.3%, 62.9% as the majority of BPD. This study would be the first report of epidemiology of Korean BPD infants by multi-center study.
Subject(s)
Humans , Infant , Infant, Newborn , Birth Weight , Bronchopulmonary Dysplasia , Dependency, Psychological , Enterocolitis, Necrotizing , Glycolates , Hemorrhage , Hospitals, General , Incidence , Infant, Premature , Intensive Care, Neonatal , Oxygen , Parturition , Prevalence , Retinopathy of Prematurity , Retrospective Studies , Survival Rate , ThoraxABSTRACT
PURPOSE: The extended-spectrum beta-lactamase(ESBL) producing organism have emerged to be an important pathogen in neonatal intensive care unit(NICU). This study was conducted to investigate incidence, characteristics and risk factors associated with ESBL organism among newborns in NICU. METHODS: The subjects included 98 newborns admitted to NICU at Asan Medical Center between September 1998 to July 2002, from whom a total of 177 ESBL organisms were detected. Annual number of isolates, distribution of cultured sites, types of illness and patient profile were retrospectively reviewed and risk factors associated with the infection were identified between control group of 115 non-infected newborns. RESULTS: Of 177 ESBL isolates, 150(84.7%) and 27(15.3%) were ESBL producing K. pneumoniae and E. coli, respectively. The annual number of isolates were 2(1.1%), 23(13.0%), 126(71.2%), 17(9.6%) and 9(5.1%) for years 1998 to 2002. The annual incidence of sepsis due to ESBL organism was 2.9%, 8.2%, 17.8%, 3.1% and 2.8% for years 1998 to 2002:Year 2000 being an outbreak. The ESBL organisms were largely found in bronchial aspirates and urine. The infected patients were younger gestational age. The mean cultivation period was at 29.1+/-2.8 days. The risk factors for infection included, in the order of frequency, total parenteral nutrition, central venous catheterization, ventilator care, respiratory distress syndrome and dexamethasone therapy. CONCLUSION: Awareness of increasing infection due to ESBL producing organism in NICU is important not only for infection control but also placing a great limit in use of antibiotics, especially in premature infants.
Subject(s)
Humans , Infant, Newborn , Anti-Bacterial Agents , beta-Lactamases , Catheterization, Central Venous , Central Venous Catheters , Dexamethasone , Epidemiologic Studies , Gestational Age , Incidence , Infant, Premature , Infection Control , Intensive Care, Neonatal , Parenteral Nutrition, Total , Pneumonia , Retrospective Studies , Risk Factors , Sepsis , Ventilators, MechanicalABSTRACT
OBJECTIVES: OCT(Point-of-Care Test), often translated as "Bedside laboratory", is a testing method used in most developed countries to conduct medical research. It is known to extract rapid results that can be applied in the intensive care unit. This study was conducted to investigate the correlation of the i-STAT(TM) POCT analyzer with the traditional test in the neonatal intensive care units. METHODS: 60 babies(birth weight > or =1.0kg) who were admitted to neonatal intensive care unit from June, 2000 to June, 2001 at Asan Medical Center requiring blood samples for the testing of arterial blood gas analysis(ABGA), electrolytes, hemoglobin(Hb), hematocrit(Hct), were included in the study. Blood samples were taken simultaneously to be tested by the traditional laboratory method and by i-STAT(TM) (i-STAT Co. USA) POCT analyzer. The data used for comparison analyzation included pH, pCO2, pO2, HCO3, Na, K, Hb, and Hct. RESULTS: 245 measurements of ABGA and 195 measurements of Na, K, Hb, Hct from 60 babies were used for comparison. Good correlation of data was found between i-STAT(TM) POCT analyzer and traditional laboratory method obtained from the central laboratory(correlation coefficient: pH 0.954, pCO2 0.944, pO2 0.941, HCO3 0.880, Na 0.713, K 0.860, Hb 0.864, Hct 0.880). CONCLUSION: This study showed that i-STAT(TM) POCT analyzer provided accurate analytic results when compared with traditional laboratory method used in the neonatal intensive care units.