A Study on Prevention and Treatment of Neonates with Lower Respiratory Tract Infection Caused by Extended-spectrum Beta-lactamase-producing Bacteria / 中华围产医学杂志

ABSTRACT

Objective To explore the risk factors, pathogenic bacteria, drug resistance and corresponding measures of prevention and treatment on lower respiratory tract infection caused by extended-spectrum beta-lactamase-producing bacteria (ESBLPB) in neonates. Methods The patieats were from the neonatal intensive care unit(NICU) of The First People's Hospital of Zhaoqing from Jan. 1998 to Apr. 2001. The secretions of the lower respiratory tract were collected, and bacterial culture and antimicrobial susceptibility testing were done. Results There were 23 positive cases in the 42 cultured cases, and 12 cases out of 23 cases were ESBLPB positive. The positive rate of ESBLPB was 52%(12/23). Of them, 9 cases (75%) had the history of using the third generation cephalosporins, 10(83%) were under mechanical ventilations, 8(67%) were lowbirth weight infants and/or premature infants. There were 21 strains in 12 cases. They were 8(38%)Klebsiella pneumoniae, 5(24%)Enterobacter cloacae, 3(14%) Escherichia coli, 3(14%) Pseudomonas aeruginosa, 1(5%)Stenotrophomonas maltophilia, 1(5%) brevi-flavobacterium strains. The ESBLPBs were sensitive to imipenem, ciprofloxacin, amikacin, levofloxacin, ticarcillin-clavulanic acid, meropenem, piperacillin but resistant to other antibiotics. Ten out of the 12 cases were fully recovered from their infection. Conclusion There are multiple factors to increase the lower respiratory tract infections caused by ESBLPB in neonates. The effective measures associated with the infection prevention include intensive sterilization and isolation, and timely immunigation.