ABSTRACT
The impact of ampicillin and cefuroxime on the bacterial flora of neonates was examined in a neonatal intensive care unit (NICU). For the first period of study (January-September 1989), ampicillin plus gentamicin were used as empirical therapy of infection. During this time, 92.6% of all Gram-negative bacilli (GNB) were resistant to ampicillin and 56.6% to cefuroxime. These percentages decreased significantly (P < 0.05) to 60.0% and 16.2% respectively, over the next period of study (October 1989-October 1990) when cefuroxime+gentamicin were used. A decrease in the number of cases of GNB from bacteraemia and meningitis was also significant (from 21.2% to 11.2%), and this correlated with a decline in the occurrence of Klebsiella pneumoniae. However, the number of enterococcal isolates and cases of enterococcal bacteraemia increased. These observations underline the important effect of ampicillin and cefuroxime in modulating the bacterial flora and its antibiotic resistance in patients on a NICU.
Subject(s)
Ampicillin/pharmacology , Cefuroxime/pharmacology , Gram-Negative Bacteria/drug effects , Infection Control , Intensive Care Units, Neonatal , Ampicillin Resistance , Bacterial Infections/drug therapy , Bacterial Infections/microbiology , Colony Count, Microbial , Croatia , Drug Resistance, Microbial , Escherichia coli/drug effects , Gram-Negative Bacteria/classification , Humans , Infant, Newborn , Klebsiella pneumoniae/drug effectsABSTRACT
Between April and September 1991, 415 injured patients were treated at the University Hospital Rebro, Zagreb, 362 at the Department of Surgery and 53 at the Department of Neurosurgery. Infections developed in 15.7% of the injured patients (wound infections in 14.6% and sepsis or meningitis in 1.1% of the injured patients). 88.2% of wound infections as well as all sepsis and meningitis were hospital-acquired infections, while 7.95 of wound infections occurred within 48 h of injuring. The major pathogens, in 90% of cases, were the aerobic bacteria (Enterobacteriaceae, Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter species) while 9% of infections were caused by mixed aerobic-anaerobic flora. One injured patient developed clinical features of gas gangrene. Neither streptococcal wound infections nor tetanus were present in this group of the injured patients.
