I Wojsyk-Banaszak1, J Szczapa. 1. Kliniki Zakazeń Noworodka Katedry Neonatologii Akademii Medycznej w Poznaniu.
Abstract
OBJECTIVE: To evaluate the incidence, clinical course and outcome of central nervous system (CNS) infections caused by multiresistant Klebsiella pneumoniae (MRKP) in critically ill neonates. METHODS: Retrospective study of neonates treated in Neonatal Department of Poznań University of Medical Science during a three years period from 1st January 1997 to 31st December 1999. Isolates were identified as Klebsiella pneumoniae with the ID32Gn test (bioMerieux), and antibiotic susceptibility was determined with ATBG test (bioMerieux) and with disc-diffusion technique. RESULTS: In this period there were 27 cases of CNS infections in our Department 17--65.4% of which (16 meningitis, one ventriculitis and one brain abscess), were caused by Klebsiella pneumoniae. 81.25% occurred in prematures (< 31 weeks of gestational age and < 1500 grams). In 10 (58.8%) cases CNSI developed in the course of sepsis. 9 children died. In all the isolates ESBL expression in vitro was detected. Only carbapenems and fluoroquinolones were active in all the cases. Ventriculitis was treated successfully with imipenem administered intraventrically and brain abscess surgically. CONCLUSIONS: CNS infections in neonates caused by MRKP are quite frequent, severe and possibly life threatening. Eradication of these strains from hospital environment by introducing adequate sanitary regime and reasonable antibiotic policies is the only method of conquering the infections.
OBJECTIVE: To evaluate the incidence, clinical course and outcome of central nervous system (CNS) infections caused by multiresistant Klebsiella pneumoniae (MRKP) in critically ill neonates. METHODS: Retrospective study of neonates treated in Neonatal Department of Poznań University of Medical Science during a three years period from 1st January 1997 to 31st December 1999. Isolates were identified as Klebsiella pneumoniae with the ID32Gn test (bioMerieux), and antibiotic susceptibility was determined with ATBG test (bioMerieux) and with disc-diffusion technique. RESULTS: In this period there were 27 cases of CNS infections in our Department 17--65.4% of which (16 meningitis, one ventriculitis and one brain abscess), were caused by Klebsiella pneumoniae. 81.25% occurred in prematures (< 31 weeks of gestational age and < 1500 grams). In 10 (58.8%) cases CNSI developed in the course of sepsis. 9 children died. In all the isolates ESBL expression in vitro was detected. Only carbapenems and fluoroquinolones were active in all the cases. Ventriculitis was treated successfully with imipenem administered intraventrically and brain abscess surgically. CONCLUSIONS:CNS infections in neonates caused by MRKP are quite frequent, severe and possibly life threatening. Eradication of these strains from hospital environment by introducing adequate sanitary regime and reasonable antibiotic policies is the only method of conquering the infections.