OBJECTIVE: To determine the neonatal sepsis prevalence and the mortality of extended-spectrum beta-lactamase producing Gram-negative bacteria (ESBL) in a Neonatal Intensive Care Unit. METHODS: This is a descriptive and retrospective study of 236 newborn infants with sepsis suspicion from 2000 to 2004. The diagnosis was confirmed by clinical signs and positive blood culture. Screening for ESBL was carried out following the National Committee for Clinical Laboratory Standards criteria. RESULTS: Eighty-four (36%) neonates showed positive blood culture. Klebsiella pneumoniae was the most prevalent agent (47%). Among the neonates with Klebsiella pneumoniae infection, seven presented ESBL infection, with an infection rate of 0.4%. All the patients with one exception had length of hospital stay greater than 21 days and needed mechanical ventilation; all the newborns used central catheters, parenteral nutrition and broad-spectrum antibiotics. Among the 84 patients with confirmed sepsis, 36 (43%) died and their blood cultures were positive for gram-negative bacteria (67%) and fungous (19%). In relation to ESBL Klebsiella pneumoniae, three (43%) neonates died. CONCLUSIONS: The prevalence of sepsis by ESBL Klebsiella pneumoniae was 0.4% and the mortality rate was 42.8%. It is important to detect and to control the spread of this infectious agent with its negative impact on the survival rate of premature and/or sick newborn infants.
Klebsiella pneumoniae; infection; sepsis; bacteria; infant, newborn