Abstract
Objectives: The aim of this study is to determine the efficacy of administrating antibiotics to prevent exchange transfusion-related nosocomial infections in newborns.
Methods: We report a survey of 36 patients of our Neonatal Unit over a two years period. Criteria for inclusion: at least 24 weeks gestation or 500 grams, no mortal congenital malformations, no infection (possible or confirmed), absence of mechanical ventilation during the exchange transfusion, and survival of more than 24 hours after the admission. At the beginning and the end of the technique blood is extracted for blood culture. A betalactamic and an aminoglucoside agents are administered intravenously when canalizing the central way, and for 7 days to one of every two newborns. Both groups are compared, not receiving antibiotics (A) and receiving antibiotics (B), evaluating positive cultures and/or diagnosis of infections. Statistical method: Odds Ratio (OR) and proves of î2 test.
Results: NW with exchange transfusion: 36 RN (18 in every group). - RN with positive cultures pre-exchange transfusion: - Group A: blood culture: 2 (staphilococcus). Others: 1: (staphilococcus). - Group B: blood culture: 1 (streptococcus B). Others: 1: (not usual gram-negative). - RN with positive cultures post- exchange transfusion: - Group A: blood culture: 1 (not identified germ). others: 5: umbilical: 1(staphilococcus), skin: 4 (2 staphilococcus, 2 klebsiella). - Group B: blood culture: 1 (staphilococcus). others: skin: 3 (2 not usual gram-negative and 1 not identified). - RN with diagnosis of infection: - Group A: -1st week of life: none. - >1week of life: 1 bacteraemia (not identified germ) and 1 onfalitis (staphilococcus). - Group B: -1st week of life: 1 septicemia (streptococcus B). - >1week of life: 1 septicemia (staphilococcus) None of these differences are, and are very far to be, statistically significant, therefore we elude to show the results of the odds ratio and of the î2 test.
Conclusion: In our means, in newborns with exchange transfusion, there are no noticeable differences for infections or positive cultures, with or without using prophylactic antibioticotherapy. Therefore, it doesn't seem useful the use of profilactical antibiotics when realizing exchange transfusion in a noninfected newborn.
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Fernández-Mayoralas, D., Jareño, N. & Caballero, J. 180 Neonatal Infection After Exchange Transfusion According To Antibiotical Therapy. Pediatr Res 56, 494 (2004). https://doi.org/10.1203/00006450-200409000-00203
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DOI: https://doi.org/10.1203/00006450-200409000-00203