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CERRAHİ YENİDOĞAN YOĞUN BAKIM ÜNİTESİNDE SEPSİS OLGULARININ DEĞERLENDİRİLMESİ

Journal Name:

  • Cerrahpaşa Tıp Dergisi

Publication Year:

  • 2001

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
In surgical neonatal intensive care units nosocomial infections and septicemia are still the leading cause of neonatal mortality. In our study 489 cases extending a period of 5 years was investigated retrospectively. Results.- 35.5% had clinical septicemia and in this group 76% had hemoculture positive septicemia. The mortality rate was 53%. In the first years, Enterobacteriaceae, Coagulase negative Staphylococci, Stenotrophomonas maltophilia sp. and Candida sp. are mostly encountered but in recent years MRSA, Pseudomonas sp, Enterobacter sp. are most common microorganisms. Although antibiotic resistance in some resistant microorganism are seen more frequently, in our series we had a remarkable decrease in septicemia and related mortality. Conclusion.- As the intense use of modern technology in neonatal surgical intensive care units improved the fight against neonatal septicemia, neonatal mortality is still due to nosocomial infections and septicemia.
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Abstract (Original Language): 
Cerrahi yeni doğan yoğun bakım ünitelerinde, nozokomiyal enfeksiyonlar ve sepsis halen başta gelen mortalite nedenidir. Bu çalışmada 5 yıllık süre içinde ünitemizde takip edilen 489 olgu sepsis açı- sından geriye dönük olarak değerlendirildi. Olguların % 35,5’inde sepsis saptandı. Bu olguların %76’sınde kan kültürlerinde etken tesbit edildi. Mortalite %53 olarak bulundu. İnceleme dönemi başlangıcında yoğun bakımda en sık görülen ve mortaliteye sebep olan mikroorganizmalar Ente- robacter sp, koagülaz negatif stafilokoklar (KNS), Stenotrophomonas maltophilia ve Candida sp. iken, son yıllarda bu flora değişerek MRSA, Pseudomonas ve Ente- robacter cinsi bakteriler ön plana çıkmışt ır. Antibiyotiklere direnç gösteren ve mü- cadelesi daha zor mikroorganizmaların üremesine karşın, serimizdeki klinik ve kültür pozitif sepsisli olguların sayısında ve mortalite oranlarında yıllar içinde anlaml ı azalma kaydedilmiştir. Yeni doğan cerrahisindeki ve cerrahi yoğun bakım ünitelerindeki teknik gelişmelere paralel olarak enfeksiyonla mücadelede de ciddi gelişmeler kaydedilmesine rağmen kliniğimizde yeni doğan mortalitesinin sebeplerinin başında halen hastane enfeksiyonları ve sepsisin geldiği görüld ü.
FULL TEXT (PDF): 
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  • 4
214-220
  • Turkish

REFERENCES

References: 

1. Leonard EM, Van Saene HKF, Shears P,
Walker J, Tam PKH. Pathogenesis of colonization
and infection in a neonatal surgical unit.
Crit Care Med 1990;18: 264-269.
2. Ilıkkan B, Vural M, Özbek S ve ark. Yenidoğan
ünitesinde sepsis olgularının değerlendirilmesi.
Cerrahpaşa Tıp Derg 1997; 28: 146-150.
3. Tessin I, Trollfors B, Thiringer K. Incidence
and etiology of neonetal septicemia and meningitis
in western Sweden 1975-1986. Acta Paediatr
Scand 1990; 79: 1023-1030.
4. Finer NN, Woo BC, Hayashi A, Hayes B. Neonatal
surgery. Intensive care unit versus operating
room. J Pediatr Surg 1993; 28: 645-649.
5. Satar M, Atıcı A, Türkmen M, Narlı N. Çukurova
üniversitesi tıp fakültesi yenidoğan yoğun
bakım ünitesinde nozokomiyal enfeksiyonlar II.
İstanbul Çocuk Kliniği Dergisi 1997; 32: 39-45.
6. Gülseren F, Mamıkoğlu L, Öztürk S ve ark. A
surveillance study of antimicrobial resistance of
gram-negative bacteria isolated from intensive
care units in eight hospitals in Turkey. J Antimicrob
Chemoth 1999; 43: 373-378.
7. Bhattacharyya N, Albuquerque ANK. Postoperative
wound infection in pediatrric surgical
patients: A study of 676 infants and children. J
Pediatr Surg 1990; 25: 125-129.
8. Davenport M, Doig CM. Wound infection in pediatric
surgery. A study 1094 neonates. J Pediatr
Surg 1993; 28: 26-30.
9. Gerald B M, Karen A, Leonard E W: Infection
in the neonate. Handbook of Neonatal Intensive
Care. Ed. Gerald B M, Sandra LG. Fourth Edition.
Missouri, Mosby, 1998; 413-435.
10. Acunas BA, Peakman M, Liossis G, et al. Effect
of fresh frozen plasma and gammaglobulin on
humoral immunity in neonatal sepsis. Arch Dis
Child 1994; 70: 182-187.
11. Vain NE, Mazlumian JR, Swarner OW, Cha
CC. Role of exchange transfusion in the treatment
of severe septicemia. Pediatrics 1980; 66:
693-697.
12. Harris MCH, Polin RA. Neonatal septicemia.
Pediatr Clin Nh Am 1983; 30: 243-257.
13. Lally KP, Cruz E, Xue H. The role of antitumor
necrosis factor-A and interleukin-10 in
protecting murine neonates from Escherichia
coli sepsis. J Pediatr Surg 2000; 35: 852-855.
14. Philip AGS, Hewitt JR. Early diagnosis of neonatal
sepsis. Pediatrics 1980; 65: 1036-1041.
15. Rove MI, Buckner DM, Newmark. The early
diagnosis of gram negative septicemia in the
pediatric surgical patient. Ann Surg 1975; 182:
280-286.
16. Fallat ME, Gallnaro RN, Stover BH, Wilkerson
S, et al. Central venous catheter bloodstream
infections in the neonatal intensive care unit. J
Pediatr Surg 1998; 33: 1383-1387.
17. Bhattacharyya N, Kosloske A, Macarthur C, et
al. Nasocomial infection in pediatric surgical
patients: A study of 608 infants and children. J
Pediatr Surg 1993; 28: 338-344.
18. Goldmann DA, Durbin WA, Freeman J. Nasocomial
infections in a neonatal intensive care
unit. J Infect Dis 1981; 44: 449-459.
19. Freeman J, Epstein MF, Smith NE, et al. Extra
hospital stay and antibiotic usage with nasocomial
coagulase negative staphylococcal bacteremia
in two neonatal intensive care unit
populations. Am J Dis Child 1990; 137: 461-
463.

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