Neonatal Infections: a 5-Year Analysis in a Neonatal Care Unit in North East of Iran

Authors

1 Associate Professor, Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran

2 Professor, Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran.

3 PhD in Reproductive Health, Department of Midwifery, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.

4 Assistant Professor, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Department of Microbiology and Virology, Antimicrobial Resistance Research Center, Avicenna Research Institute, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

6 Associate Professor, Pediatric Gastrointestinal Department of Mashhad University of Medical Sciences, Mashhad, Iran.

7 Fellowship of Neonatology, Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran

8 Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

9 Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

10 MSc. in Neonatal Intensive Care, Faculty member of Azad University, Mashhad, Iran.

Abstract

Background: Neonatal infections are one of the major causes of death in Iran. Since identifying the risk factors, types, site, bacterial causes, and case fatality rate of an infection can be effective in selecting preventive and therapeutic methods, and appropriate supportive measures, this study aimed to investigate the aforementioned factors in the neonatal intensive care unit (NICU) of Ghaem Hospital in Mashhad- Iran during a 5-year period.
Materials and Methods: This cross-sectional study was conducted from Jan 2010 to Jun 2016 on 221 infants diagnosed with infections (positive blood, cerebrospinal fluid, or urine cultures, and radiographic evidence of lung infection as well as laboratory and clinical evidence of infection). Data collection tools consisted of a researcher-made questionnaire including maternal and neonatal characteristics and clinical and laboratory evaluation. Moreover, the infants were followed up until hospital discharge or death. Data were analyzed using SPSS-16.
Results: The incidence of neonatal infection was 11.6%. About 70% of the infants were born preterm and 52% of the infected infants were born by cesarean. The most common pathogens of sepsis were gram-negative bacteria (55%), coagulase-negative staphylococci (35%) and other gram-positive bacteria (10%). There were three main causes of infection of central nervous system (CNS): Klebsiella (66%), Escherichia coli (17%), and Acinetobacter (17%). Infant mortality rate due to infection was 28.1%. The causes of death included meningitis (60%), sepsis (27%), and UTI (16%).
Conclusion: According to our study, the prevalence of infection and mortality rate in our ward is higher compared to developed countries. The most common cause of infections was gram-negative bacteria, but coagulase-negative staphylococci become more prevalent and needs more attention.

Keywords