[Analysis of risk factors for nosocomial infections in the Neonatal Intensive Care Unit of the Pomeranian Medical University in Szczecin in the years 2005-2008]. / Analiza czynników ryzyka zakazen szpitalnych w Oddziale Intensywnej Terapii Noworodka Kliniki Neonatologii PAM w Szczecinie w latach 2005-2008.

UNLABELLED: The aim of the study was to assess the significance of some perinatal risk factors and neonatal complications in occurrence of nosocomial infections in the population of NICU patients. MATERIAL AND METHODS: Analysis of risk factors was performed in all patients treated in the years 2005-2008 in NICU Department of the Pomeranian Medical University in Szczecin, Poland. Five hundred and seventeen neonates divided into groups with and without occurrence of nosocomial infection were included into the study. RESULTS: Seventy-nine (15.28%) neonates developed nosocomial infection. Among them pneumonia (56.96%) and sepsis (21.5%) were the most common. The proportion of Gram-positive and Gram negative organisms were 44.3% and 50.6% respectively. The main risk factor for nosocomial infection was colonization (sensitivity--100% and specificity--94.75%). Univariate analysis showed that premature rupture of fetal membrane, GA<32 hbd, birthweight <2000 g, respiratory insufficiency intracranial hemorrhages and oral feeding intolerance were associated with the development of nosocomial infection. Multivariate stepwise logistic regression analysis showed that mechanical ventilation - OR 9.42 [4.45-19.96] p<0.0001, intracranial hemorrhages--OR 4.12 [2.21-7.67] p<0.0001, necessity of Infant-Flow method--OR 3.32 [1.82-6.06] p<0.0001or n-CPAP method--OR 1.92 [1.07-3.44] p<0.05, necrotizing enterocolitis--OR 2.38 [1.17-4.87] p<0.05 and intrauterine hypotrophy--OR 1.8 [1.07-3.76] p<0.05 were sets of predicted factors for the development of nosocomial infection. We conclude that colonization of NICU patients with hospital pathogens is the most important risk factor of nosocomial infection incidence. Besides colonization, significant additional risk factors for nosocomial infection were mechanical ventilation, intraventricular hemorrhages, low birth weight and low gestational age.

[Assessment of relationship between cord blood cotinine levels and some factors of perinatal hypoxia]. / Ocena zaleznosci miedzy stezeniem kotyniny we krwi pepowinowej a wybranymi wskaznikami niedotlenienia okoloporodowego.

OBJECTIVE: To determine the relationship between cord blood cotinine levels and some markers of perinatal hypoxia such as cord blood erythropoietin levels, parameters of umbilical arterial blood gas analysis and Apgar scores. METHODS: 150 women with uncomplicated, healthy singleton pregnancies were assessed by means of a patient questionnaire. Neonates born by the examined pregnant women were divided into 3 groups according to recorded maternal smoking status--active smoking: n = 51, passive smoking: n = 49, non smoking: n = 50. Immediately after birth umbilical venous (for cotinine and erythropoietin levels) and arterial blood (for pH, pO2, pCO2, BE) were collected. RESULTS: Cotinine levels were significantly higher (p < 0.00001) in active smoking group (Me = 19.3 ng/ml) than in passive smoking (Me = 0.75 ng/ml) and non smoking (Me = 0.72 ng/ml) ones. Cord blood erythropoietin, pH values and 1, 3 and 5-minute Apgar scores did not differ significantly between the study groups. No significant correlation between cotinine and erythropoietin, pH and Apgar scores results in all study material and in the compared groups was found. CONCLUSION: No correlation between cord blood cotinine and erythropoietin levels was detected. Cord blood cotinine concentration does not influence the condition of the newborn assessed by Apgar scores and umbilical arterial blood gas analysis.