Wójkowska-Mach Jadwiga, Różańska Anna, Borszewska-Kornacka Maria, Domańska Joanna, Gadzinowski Janusz, Gulczyńska Ewa, Helwich Ewa, Kordek Agnieszka, Pawlik Dorota, Szczapa Jerzy, Heczko Piotr B
Chair of Microbiology, Jagiellonian University Medical College, Kraków, Poland.
Clinic of Neonatology and Intensive Neonatal Care, Warsaw Medical University, Warsaw, Poland.
PLoS One. 2014 Mar 21;9(3):e92865. doi: 10.1371/journal.pone.0092865. eCollection 2014.
The aim of this study was to describe the epidemiology of necrotising enterocolitis (NEC), antibiotic consumption and the usefulness of microbiological tests in very low birth weight (VLBW) Polish newborns.
Prospective surveillance was performed in the year 2009 by local infection control teams. The study covered 910 infants hospitalized in six Polish neonatal intensive care units. Two kinds of indicators were used for the description of antibiotic usage: the duration of treatment (days of treatment, DOTs) and the defined daily dose (DDD).
NEC incidence was 8.7% and fatality rate was 19%. Chorioamnionitis, late gestational age and low birth weight were identified as risk factors for NEC. Catheterization, mechanical ventilation and other selected procedures were used considerably longer in newborns with NEC than in the remaining neonates. Total usage of antibiotics reached 2.9 DDDs or 1.437 days; the average use of drugs per case of NEC amounted to 0.47 DDD or 23.2 DOTs. The level of antibiotic usage was analysed with correlation to microbiological tests performed and it was non-significantly greater in the group of children with NEC in whom the tests were performed.
A high risk of developing NEC is closely associated with VLBW and with inflammation of the amnion during labour. We observed no relationship between the consumption of antibiotics in neonates with NEC and positive results of microbiological testing indicating sepsis accompanying NEC or gut colonization with pathogens.
本研究旨在描述坏死性小肠结肠炎（NEC）的流行病学、抗生素使用情况以及微生物检测在波兰极低出生体重（VLBW）新生儿中的作用。
2009年由当地感染控制团队进行前瞻性监测。该研究涵盖了在波兰六个新生儿重症监护病房住院的910名婴儿。使用两种指标来描述抗生素使用情况：治疗持续时间（治疗天数，DOTs）和限定日剂量（DDD）。
NEC发病率为8.7%，死亡率为19%。绒毛膜羊膜炎、孕晚期和低出生体重被确定为NEC的危险因素。与其余新生儿相比，NEC新生儿使用导尿管、机械通气和其他选定程序的时间要长得多。抗生素总使用量达到2.9 DDDs或1.437天；每例NEC患儿的平均用药量为0.47 DDD或23.2 DOTs。分析了抗生素使用水平与所进行的微生物检测之间的相关性，结果显示在进行检测的NEC患儿组中，抗生素使用水平略高，但无显著差异。
发生NEC的高风险与极低出生体重以及分娩时羊膜炎症密切相关。我们未观察到NEC新生儿的抗生素使用与微生物检测阳性结果之间存在关联，微生物检测阳性结果表明NEC伴有败血症或肠道病原菌定植。
