Üçüncü basamak bir yenidoğan yoğun bakım ünitesinde metisilin dirençli Staphylococcus aureus kan dolaşımı enfeksiyonlarının görülme sıklığı ve risk faktörleri

Abstract

Objective: Methicillin-resistant Staphylococcus aureus (MRSA) infections are significant causes of morbidity and mortality for the patients in neonatal intensive care unit (NICU). The identification of risk factors that lead up to the development of MRSA infections is of utmost importance in terms of preventing infections. In this study, we aim to determine the risk factors of MRSA infections. Material and Methods: This retrospective study was conducted in a tertiary NICU between 1 st January 2011 and 31 st December 2015. All patients with S. aureus isolated from blood cultures were included in the study. According to the antibiogram pattern, the patients were separated into two groups: MRSA and methicillin-susceptible Staphylococcus aureus (MSSA). Results: S. aureus infections were more frequent in infants under 1500 g (2.27%) than in infants of 1500 g and above (0.23%) [OR=10.149, CI: 5.790-17.790, p<0.001]. MSSA was identified in 79.6% (43 of 54) of cases, and MRSA strains were identified in 20.4% (11 of 54) of cases. Although, MRSA infections were more frequent in infants under 1500 g than in infants of 1500 g and above, there was no statistically significant association between MRSA and birth weight [OR=1.580, CI: 0.366-6.831, p=0.728]. We found that birth weight, gestational age, sex, SNAPPE score, therapeutic procedures (central venous catheter, total parenteral nutrition, assisted ventilation) and antibiotics used (prenatal or empirical) did not make a significant difference in terms of methicillin resistance. Conclusion: Very low birth weight is the most important risk factor for both S. aureus infections.