Yenidoğan yoğunbakım ünitesinde izlenen prematüre bebeklerde sepsis gelişimi ile beyaz küre ve trombosit sayılarının ilişkisi.
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Tarih
2007
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
In this study, it is aimed to investigate the identification of extended spectrum p-Iactamases (GSBL) of 960 Eseheriehia eoli ve 300 Klebsiella spp which were isolated from wound and urine Ispecimens of hospitalized patients and outpatients, and their resistance to same anti-biotics, by double disc sinergy test and phenotipical confirmatory test. The bacteria were isolated by standart methods. Antibiotic resistance was tested by disc diffusion method, while, double disc sinergy test and phenotipical confirmatory tests were used to find the existence of GS BL. All the tests were done according to criteria of the National Commit!ee for Clinical Laboratory Standarts(NCCLS). The Fisher's ki-square test was used to show the antibiotic resistance. 162 of 960 E. eoli strains (%16,8) and 66 of 300 Klebsiella spp strains (%22) (54 of which K. pneumoniae (%18) and 12 of which was K. oxytoea (%8) were found to be positive. The resistance of amicasin of the GS BL positive strains has been found %5,9 in the urine material, while it was %14,5 in the wound material and it was statistically significant (p <0,031 ). Consequently, the disc diffusion test, double disc sinergy test and the phenotipical contirmative tests were found to be compatible and it is determined that there is a necessity to be careful for the amicasin resistance in the strains isolated from the GSBL posilive wound samples. Keywords: Exlended-speclrum p-Iaclamases, Resistance of antibiolics, Klebsiella spp., E. eoli.değişiklikler değerlendirilmış ve sepsis gelişen ve gelişmeyen bebeklerden elde edilen ölçümlerin (1., 3., 5., 7. günlerdeki) karşılaştırılması yapılmıştır. Araştırma sonucunda elde edilen veriler SPSS programında analiz edilerek p< 0.05 anlamlılık sınırı olarak kabul edilmiştir. Çalışmaya alınan tüm olguların % 14'ünde ilk hafta içinde sepsis gelişmiştir. Sepsis grubu ve kontrol grubu arasında gebelik haftası ve doğum ağırlığı açısından farklar anlamlı bulunmuştur. Gruplar arasında cinsiyet dağılımı , doğum şekli , annelerin yaş ortalaması , gebelik sayısı , hipertansiyon, diyabet, erken membran rüptürü ve preeklampsi oranları açısından fark bulunmamıştır. Hem 1. ve 5. dakika Apgar skorları hem de resüsitasyon uygulanma oranları anlamlı farklılık göstermiştir. Sepsis ve sepsis olmayan gruplar arasında lökosit sayıları açısından fark bulunamazken sepsis ve kontrol grubu arasında 1, 3, 5. ve 7. günlerde bakılan hem trombosit sayıları hem de trombositopeni oranları açısından arasındaki farklar oldukça anlamlı bulunmuştur . Bu çalışma sonucunda, ilk hafta içerisinde alınan ardışık kan örneklerinde sepsis geliştiren bebeklerde yaşamın ilk gününden başlayarak hem ortalama trombosit sayısının daha düşük hem de trombositopeni oranlarının anlamlı şekilde yüksek olduğu görülmüştür. Anahtar kelimeler: Trombosit sayısı , lökosit sayısı , sepsis, yenidoğan
The rate of mortality is deereated signifieanııy in prematurity and its coneomitant problems depending on the improvement in neonatal intensive care. On the other hand mortalities and morbidities due to sepsis are stili high. Humoral and eellular defans meehanisms are poorly developed in neonatal period. It explains high rate of morbidities in premature neonates. While weeks of pregnancies deerease, the rate of infeetions increases. Sepsis whieh represents sings and symptoms within first week usually progresses rapidly and effeets multiple organs. Most of the affeeted neonates are premature and have low birth weighl. Mieroorganisms eausing infeetions have maternal origin. And mortality rates are higher than Iate sepsis. Early diagnosis and proper management are very important to reduee mortalities and for good prognosis. The diagnosis usually depends on clinie of neonates. Howewer sing of sepsis may not be present at the beginning or or other pathological conditions that mimic sepsis during this period make diagnosis difficull. A number of screaning tests are available for early diagnosis. Howewer test of choice must be sensitive, can be done easily and should give fast results. By this study we aimed to eveluate the relations between hematological parameters that that includes leucocyte count and changes in platelet numbers and sepsis in premature neonates in neonatal interısive care units. AIso we aimed to eveluate how those parameters may prediet sepsis or help to diagnose sepsis and is there any relation between the duration and the range of changes in parameters and clinical course, prognosis of disease and responsible microorganisms. We included 207 premature neonate who are under 37 weeks of gestational age and in neonatal intensive care units into study. Hematological parameters weremeasured eonseeutively at 1, 3, 5. and 7. days. The changes in the parameters within the first week were evaluated. Results of sepsis developed group and control groups were compared.for statistical analysis we used SPSS programs. P values < 0.05 were accepted as a border for statistical signifance. The rate of sepsis was 14 % within first week. Gestational age and birth weight differences were statistically significant in sepsis group and control groups. There were no differences between the groups according to sexes, types of delivery, maternal age, number of pregnancies, history of hypertantion, diabetes, premature rupture of membrane and preeclamycia. APGAR scores at 1 and 5 minutes and resusoutation rates were significantly different. Leucocyte counts were similar howewer platelet numbers at 1, 3, 5. and 7. days and rate of thrombocytopenia were significanııy different in septic groups and control groups. As a conclusion, analysis of consecutive hematological parameters showed that the mean platelet numbers is lower and the rate of thrombocy,t openia is higher in sepsis developed group in comparison with control group. Key words: Platelet count, leucoeytes count, sepsis, newbom
The rate of mortality is deereated signifieanııy in prematurity and its coneomitant problems depending on the improvement in neonatal intensive care. On the other hand mortalities and morbidities due to sepsis are stili high. Humoral and eellular defans meehanisms are poorly developed in neonatal period. It explains high rate of morbidities in premature neonates. While weeks of pregnancies deerease, the rate of infeetions increases. Sepsis whieh represents sings and symptoms within first week usually progresses rapidly and effeets multiple organs. Most of the affeeted neonates are premature and have low birth weighl. Mieroorganisms eausing infeetions have maternal origin. And mortality rates are higher than Iate sepsis. Early diagnosis and proper management are very important to reduee mortalities and for good prognosis. The diagnosis usually depends on clinie of neonates. Howewer sing of sepsis may not be present at the beginning or or other pathological conditions that mimic sepsis during this period make diagnosis difficull. A number of screaning tests are available for early diagnosis. Howewer test of choice must be sensitive, can be done easily and should give fast results. By this study we aimed to eveluate the relations between hematological parameters that that includes leucocyte count and changes in platelet numbers and sepsis in premature neonates in neonatal interısive care units. AIso we aimed to eveluate how those parameters may prediet sepsis or help to diagnose sepsis and is there any relation between the duration and the range of changes in parameters and clinical course, prognosis of disease and responsible microorganisms. We included 207 premature neonate who are under 37 weeks of gestational age and in neonatal intensive care units into study. Hematological parameters weremeasured eonseeutively at 1, 3, 5. and 7. days. The changes in the parameters within the first week were evaluated. Results of sepsis developed group and control groups were compared.for statistical analysis we used SPSS programs. P values < 0.05 were accepted as a border for statistical signifance. The rate of sepsis was 14 % within first week. Gestational age and birth weight differences were statistically significant in sepsis group and control groups. There were no differences between the groups according to sexes, types of delivery, maternal age, number of pregnancies, history of hypertantion, diabetes, premature rupture of membrane and preeclamycia. APGAR scores at 1 and 5 minutes and resusoutation rates were significantly different. Leucocyte counts were similar howewer platelet numbers at 1, 3, 5. and 7. days and rate of thrombocytopenia were significanııy different in septic groups and control groups. As a conclusion, analysis of consecutive hematological parameters showed that the mean platelet numbers is lower and the rate of thrombocy,t openia is higher in sepsis developed group in comparison with control group. Key words: Platelet count, leucoeytes count, sepsis, newbom
Açıklama
Anahtar Kelimeler
Çocuk Sağlığı ve Hastalıkları, Child Health and Diseases
