RESUMO
BACKGROUND: In July 2007, three neonates in the neonatal intensive care unit (NICU) of Chosun University Hospital expired due to Escherichia coli sepsis. An E. coli outbreak was suspected. METHODS: To investigate the outbreak, environmental cultures were taken from NICU. We performed repetitive extragenic palindromic (rep)-PCR to compare genotypes of the three isolates from the cases and one environmental strain of E. coli. A case-control study was done in order to identify risk factors for the infection. RESULTS: In July 2007, the attack rate of E. coli was 11.1%, which was higher than the basal rate. All the three E. coli isolates from the cases presented the same antimicrobial susceptibility pattern whereas other E. coli isolated from non-outbreak period presented different patterns. Among environmental cultures, only one specimen collected from the surface of a bathtub for neonates was culture positive for E. coli. Three strains of the cases and one environmental strain of E. coli showed the same rep-PCR pattern, while control strains showed different patterns. No statistically significant difference in risk factors was found between the case and control groups in the case-control study. CONCLUSION: The result of rep-PCR assay showed that the outbreak had originated from a single clone of E. coli. But we could not identify risk factors for the infection. The attack rate of E. coli in NICU returned to the basal level after implement of the infection control measures such as disinfection of NICU environment and equipments, thorough hand washing, and education of health care workers.
Assuntos
Humanos , Recém-Nascido , Estudos de Casos e Controles , Células Clonais , Atenção à Saúde , Surtos de Doenças , Desinfecção , Escherichia , Escherichia coli , Infecções por Escherichia coli , Genótipo , Desinfecção das Mãos , Controle de Infecções , Unidades de Terapia Intensiva Neonatal , Terapia Intensiva Neonatal , Reação em Cadeia da Polimerase , Sequências Repetitivas de Ácido Nucleico , Fatores de Risco , Sepse , Entorses e DistensõesRESUMO
A clinical and hematological observation was performed on 136 newborn infants who were admitted to dept. of Pediatrics of Chosun University Hospital from Junly, 1976 to June, 1980 and were diagnosed of neonatal hyperbilirubinemia. The following results were obtained 1) The incidence of hyperbilirubinemia in male (64.0%) was more than female. 2) The highest monthly incidence was seen in June with 23 cases. (16.9%) 3) In the observation of the gestational period, its incidence was highest in full-term neonate with 103 cases. (79.3%). The mean value of serum bilirubin was highest in postmature neonate (19.70mg%). 4) In the obseervatio of the delivery type, the mean value of serum bilirubin was highest in vacuum and forcep delivery (17.81mg%). 5) The mean value of serum bilirubin was more higher in those of low birth weight group. 6) In the distribution of peak value of serum bilirubin, a group of 10.1~20.0mg% occupied 75.7%. 7) Idiopathic hyperbilirubinemia was the most common cause of pathological hyper bilirubinemia, with 79 cases. (58.1%). In the group of blood incompathibily, visible jaundice was begun earliest and mean value of serum bilirubin was highest. 8) Sepsis among the infection was the most important factor in the cause of neonatal hyper bilirubinemia with 18 cases (51.4%). 9) The most common blood types of mother-baby in ABO blood incompatibility was O-B with 8 cases (61.5%). 10) The exchange transfusions were performed on 13 cases (9.5%) and the rate of performance was the highest in blood incompatibility.
