Clinical Study On Bacterial Colonization And Antibiotic Resistance In Neonatal Intensive Care Unit

Background: The aim of this study is to investigate bacteria colonization andanalyze the antibiotic resistance of the colonized bacteria on newborns in theneonatal intensive care unit(NICU).Methods: A retrospective cohort study was conducted in a university hospitalNICU in Wuhan. A total of307nasopharyngeal (throat) swabs specimens weredone among186hospitalized newborn babies from study period (fromJuly2010to February2012).Bacterial prevalence were examined with themethod of throat swab culture during hospitalization at least once a week.Clinical data and the result of the bacterial surveillance were collected.. Somebabies were subjected to more than one throat swab due to their extended stayin NICU and one positive throat swab culture sometimes showed more thanone pathogens.Results: Among the307specimens collected,105were positive and202werenegative. From the105positive specimens,131organisms were isolated with130gram negative bacteria and only one gram positive organism. The mostcolonized organisms in NICU were E.coli(31.3%), Klebsiellapneumoniae(30.5%) and Stenotrophomonas maltophilia(12.2%).The mostsusceptible antibiotic for the gram negative organisms in NICU weremeropenem and imipenem.It was found that gram negative bacteria especiallyE.coli and Klebsiella pneumoniae were highly resistant toampicillin,cefuroxime,cefotaxime and piperacillin with drug resistant ratesas high as97.8%,86.0%,83.2%and75.4%.However,when a beta lactamaseinhibitor (sulbactam,clavulanic acid and tazobactam)is used in combinationwith another antibiotic,the rate of drug resistance decreased consequently.Weinvestigated the occurrence and drug resistance of extended spectrum beta lactamases. From41colonies of E.coli,ESBLs was100%and was90%for the40colonies of Klebsiella pneumoniae.CONCLUSION: We can conclude that gram negative organisms are moreprevalent in the NICU and they are highly resistant to cephalosporins and otherbeta lactams but susceptible to carbapenems. The knowledge of the organismsprevalent in the NICU and their antibiotic sensitivity is very important and canhelp the health care workers for the judicious use of antimicrobials in the NICUthus getting the optimum results for prevention of antibiotic resistance andprovide referrence of clinical rational antibiotic administration.