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BioMed Research International
Volume 2013 (2013), Article ID 756209, 8 pages
http://dx.doi.org/10.1155/2013/756209
Clinical Study

Frequency and Characteristics of Infections Caused by Extended-Spectrum Beta-Lactamase-Producing Organisms in Neonates: A Prospective Cohort Study

1Department of Paediatrics & Neonatology, PGIMER & Associated Dr. Ram Manohar Lohia Hospital, Baba Kharag Singh Marg, New Delhi 110001, India
2Department of Microbilogy, PGIMER & Associated Dr. Ram Manohar Lohia Hospital, Baba Kharag Singh Marg, New Delhi 110001, India

Received 16 April 2013; Revised 26 July 2013; Accepted 12 August 2013

Academic Editor: Kurt G. Naber

Copyright © 2013 Nandini Vijayakanthi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This prospective cohort study was conducted to determine the frequency of infections caused by extended-spectrum beta-lactamase- (ESBL-) producing organisms, various bacteria producing ESBL, antibiotic susceptibility of these organisms, and the risk factors associated with these infections in a neonatal intensive care unit in a tertiary care hospital in North India. Of the 150 neonates enrolled in the study, 47 culture-positive neonates were included in the study cohort and were divided into two groups: ESBL-positive (8 neonates) and ESBL-negative (39 neonates) cohorts. Various organisms were isolated from 72 culture samples in these 47 neonates. Of these, 10 culture samples grew ESBL-positive organisms and 62 samples grew ESBL-negative organisms. The frequency of ESBL-producing organisms was found to be 5.3%. ESBL infection incidence densities were found to be 3.4 per 1000 patient-days. Klebsiella (60%) was the most common organism producing ESBL followed by Escherichia coli (30%) and Pseudomonas (10%). Eighty percent of the ESBL-producing organisms were sensitive to piperacillin-tazobactam. Risk factors found significant by univariate analysis ( ) were preterm, low birthweight, perinatal asphyxia, respiratory distress syndrome, anaemia, metabolic acidosis, prolonged mechanical ventilation (>7 days), length of hospitalization, length of level 3 stay, prior antibiotic use, central venous catheter duration, peripherally inserted central venous catheter duration, and total parenteral nutrition duration. Factors that retained significance in the logistic regression model were duration of hospital stay (adjusted OR: 0.958, CI: 0.920–0.997, and value = 0.037) and gestational age (adjusted OR: 1.39, CI: 1.037–1.865, and value = 0.028). There was no significant difference in the mortality between the two groups.