Cytokine gene polymorphism associations with congenital cytomegalovirus infection and sensorineural hearing loss.

Cytomegalovirus (CMV) is the most common viral agent of congenital infections and a leading nongenetic cause of sensorineural hearing loss (SNHL). The host immunologic factors that render a developing foetus prone to intrauterine CMV infection and development of hearing loss are unknown. The aim of this study was to assess the potential associations between the polymorphisms within cytokine and cytokine receptors genes, and the risk of congenital CMV infection, and the hearing outcome. A panel of 11 candidate single nucleotide polymorphisms (SNPs): TNF rs1799964, TNF rs1800629, TNFRSF1A rs4149570, IL1B rs16944, IL1B rs1143634, IL10 rs1800896, IL10RA rs4252279, IL12B rs3212227, CCL2 rs1024611, CCL2 rs13900, CCR5 rs333 was genotyped in 470 infants (72 with confirmed intrauterine CMV infection and 398 uninfected controls), and related to congenital CMV infection, and the outcome. In multivariate analysis, the IL1B rs16944 TT and TNF rs1799964 TC genotypes were significantly associated with intrauterine CMV infection (aOR = 2.32; 95% CI, 1.11-4.89; p = 0.032, and aOR = 2.17, 95% CI, 1.25-3.77; p = 0.007, respectively). Twenty-two out of 72 congenitally infected newborns had confirmed SNHL. Carriers of CT or TT genotype of CCL2 rs13900 had increased risk of hearing loss at birth and at 6 months of age (aOR = 3.59; p = 0.028 and aOR = 4.10; p = 0.039, respectively). This is the first study to report an association between SNPs in IL1B, TNF, and CCL2, and susceptibility to congenital CMV infection (IL1B and TNF) and SNHL (CCL2).

Antibiotic consumption in laboratory confirmed vs. non-confirmed bloodstream infections among very low birth weight neonates in Poland.

BACKGROUND: Newborns are a population in which antibiotic consumption is extremely high. Targeted antibiotic therapy should help to reduce antibiotics consumption. The aim of this study was an assessment of antibiotic usage in bloodstream infections treatment in the Polish Neonatology Surveillance Network (PNSN) and determining the possibility of applying this kind of data in infection control, especially for the evaluation of standard methods of microbiological diagnostics. METHODS: Data were collected between 01.01.2009 and 31.12.2013 in five teaching NICUs from the PNSN. The duration of treatment in days (DOT) and the defined daily doses (DDD) were used for the assessment of antibiotics consumption. RESULTS: The median DOT for a single case of BSI amounted to 8.0 days; whereas the median consumption expressed in DDD was 0.130. In the case of laboratory confirmed BSI, median DOT was 8 days, and consumption-0.120 DDD. Median length of therapy was shorter for unconfirmed cases: 7 days, while the consumption of antibiotics was higher-0.140 DDD (p < 0.0001). High consumption of glycopeptides expressed in DOTs was observed in studied population, taking into account etiology of infection. CONCLUSIONS: Even application of classical methods of microbiological diagnostics significantly reduces the consumption of antibiotics expressed by DDD. However, the high consumption of glycopeptides indicates the necessity of applying rapid diagnostic assays. Nevertheless, the assessment of antibiotic consumption in neonatal units represents a methodological challenge and requires the use of different measurement tools.

Influence of preterm delivery on ghrelin and obestatin concentrations in maternal plasm, milk and their expression in mammary epithelial cells.

Ghrelin and obestatin are gastrointestinal peptides with a potential role in the programming of metabolism in newborns. The present study aimed to investigate the influence of preterm delivery on ghrelin and obestatin concentrations in the maternal blood plasma and breast milk as well as their gene expressions in the mammary epithelial cells (MECs). On the 3rd day after delivery, milk and plasma samples were collected from mothers that carried to term or gave birth prematurely (< 36 weeks of gestation) and analyzed for ghrelin and obestatin concentrations. MECs isolated from the milk were analyzed for the relative expression of GHRL splice variants. In both groups ghrelin concentrations were significantly lower in milk than in blood plasma. In the preterm group obestatin concentrations were significantly higher in milk than in blood plasma but significantly lower in comparison to that of the control mothers. The expression of GHRL mRNAs was higher (P < 0.05) in MECs isolated from the preterm group as compared to those isolated from control mothers. The concentration of obestatin (but not ghrelin) in the breast milk is dependent on the term of pregnancy. Moreover, the lactating mammary gland is one of the sources of ghrelin and obestatin.

Gut microbiota analysis reveals a marked shift to bifidobacteria by a starter infant formula containing a synbiotic of bovine milk-derived oligosaccharides and Bifidobacterium animalis subsp. lactis†CNCM I-3446.

Non-digestible milk oligosaccharides were proposed as receptor decoys for pathogens and as nutrients for beneficial gut commensals like bifidobacteria. Bovine milk contains oligosaccharides, some of which are structurally identical or similar to those found in human milk. In a controlled, randomized double-blinded clinical trial we tested the effect of feeding a formula supplemented with a mixture of bovine milk-derived oligosaccharides (BMOS) generated from whey permeate, containing galacto-oligosaccharides and 3'- and 6'-sialyllactose, and the probiotic Bifidobacterium animalis subsp. lactis (B. lactis) strain CNCM I-3446. Breastfed infants served as reference group. Compared with a non-supplemented control formula, the test formula showed a similar tolerability and supported a similar growth in healthy newborns followed for 12 weeks. The control, but not the test group, differed from the breast-fed reference group by a higher faecal pH and a significantly higher diversity of the faecal microbiota. In the test group the probiotic B. lactis increased by 100-fold in the stool and was detected in all supplemented infants. BMOS stimulated a marked shift to a bifidobacterium-dominated faecal microbiota via increases in endogenous bifidobacteria (B. longum, B. breve, B. bifidum, B. pseudocatenulatum).

Infections and risk-adjusted length of stay and hospital mortality in Polish Neonatology Intensive Care Units.

BACKGROUND: The objectives of this study were to analyze the impact of infections on prolonging hospital stay with consideration of underlying risk factors and determining the mortality rates and its association with infections. METHODS: An electronic database developed from a continuous prospective targeted infection surveillance program was used in the study. Data were collected from 2009 to 2012 in five Polish tertiary academic neonatal intensive care units (NICUs). The length of stay (LOS) of 2,003 very low birth weight (VLBW) neonates was calculated as the sum of the number of days since birth until death or until reaching a weight of 1,800g. RESULTS: The median LOS for neonates with infections was twice as high as for neonates without infection. LOS was significantly affected by the overall general condition of the neonate, as expressed by both gestational age and birth weight as well as by the Clinical Risk Index for Babies (CRIB) score; another independent factor was presence of at least one infection. Risk of in-hospital mortality was significantly increased by male sex and vaginal birth and was lower among breastfed neonates. Deaths were significantly more frequent in neonates without infection. CONCLUSIONS: The general condition of VLBW infants statistically increase both their risk of mortality and LOS; this is in contrast to the presence of infection, which significantly prolonged LOS only.

Impact of the shift to neonatal noninvasive ventilation in Poland: a population study.

OBJECTIVE: This study was undertaken to document the real impact of a directed shift in the standard of neonatal practice to a pervasive use of noninvasive respiratory support. DESIGN: Before-after observational study. SETTING: All 18 neonatal ICUs in the capital region of Poland. PATIENTS: Every infant admitted to a neonatal ICU who received respiratory pressure support over a 7-year period of interest (12-month transition to the new noninvasive standard and 36 months before and after). INTERVENTION: Education as to the benefits of noninvasive respiratory support and widespread availability of Infant Flow noninvasive ventilation systems. MEASUREMENTS AND MAIN RESULTS: Five thousand five hundred fifty-one infants required respiratory support in this period. Of these, 14% were less than 28 weeks estimated gestational age, 33% between 28 and 32 weeks, 31% between 33 and 36 weeks, and 22% more than 36 weeks. The use of noninvasive support, as the first form of respiratory support, increased by 19% (p < 0.001). The use of noninvasive support, for weaning following extubation, increased by 32% (p = 0.06). The increased use in weaning was the most pronounced in infants younger than or equal to 32 weeks estimated gestational age (p < 0.001). There were two prospective primary endpoints, mortality and bad outcome among survivors younger than or equal to 32 weeks estimated gestational age. Mortality decreased from 11% to 7%, and the difference remained statistically significant after controlling for baseline factors (p < 0.001). The reduced mortality was more apparent in infants younger than or equal to 32 weeks estimated gestational age. In infants younger than or equal to 32 weeks estimated gestational age, bad outcome in survivors (grade III bronchopulmonary dyplasia and retinopathy of prematurity requiring laser treatment) did not increase (p = 0.669) after controlling for significant baseline variables. CONCLUSIONS: We believe that the adoption of an approach emphasizing noninvasive ventilation in Poland resulted in decreased mortality without an increase in significant pulmonary or retinal morbidity.

Assessment of brain oxygenation in term and preterm neonates using near infrared spectroscopy.

PURPOSE: The aim of this study was to determine brain oxygenation in full-term and preterm neonates using near infrared spectroscopy. MATERIAL AND METHODS: A total of 88 full-term and preterm newborn infants without hypoxic-ischaemic disorders admitted to the NICU were examined using NIRS on the first day of life and on day 28 of life. Additional measurements were taken at the end of the first week of life in the premature neonates group. Measurements of oxyhaemoglobin (HbO2), deoxyhaemoglobin (Hb), total haemoglobin (HbT) concentration and tissue oxygen saturation (Ox) were performed in 5 brain regions. Right and left frontal areas, the occipital area and right and left temporal areas were measured. RESULTS: In full-term healthy neonates a marked decrease in HbO, Hb and HbT values was observed on day 28 of life in all brain regions except the occipital area. In the neonatal period the greatest changes in brain oxygenation occurred in the right and left frontal regions of the brain. In preterm neonates constant values of HbO2 and Ox were observed in the first 28 days of life. In preterm newborn infants, as well as in full term newborn infants, similar Ox and HbO2 values were obtained on day 28 of life. CONCLUSIONS: NIRS is a safe method and can be used to evaluate brain oxygenation in newborn infants. The results of these measurements are in accordance with changes in brain oxygenation in the first month of life, which are predicated on the basis of the neonate's physiology.

Effect of maternal tobacco smoking or exposure to second-hand smoke on the levels of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) in urine of mother and the first urine of newborn.

Tobacco smoking during pregnancy is associated with a variety of negative consequences not only for the mother, but also for the developing fetus. Many studies have shown that carcinogens contained in tobacco smoke permeate across the placenta, and are found in fetus. The aim of the study was to determine the prenatal exposure to tobacco-specific carcinogenic N-nitrosamines on the basis of measurements of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) in urine of smoking and second-hand smoke (SHS) exposed women and in the first urine of their newborns. A questionnaire documenting demographics and socio-economical data, smoking habits and exposure to SHS was completed by 121 delivering women near or at term. Maternal concentrations of cotinine and NNAL were measured in urine of the mother and the first urine of her newborn infant by liquid chromatography tandem mass spectrometry (LC/MS/MS). The mean concentration of cotinine was 439.2 ng/mg creatinine and NNAL concentration in urine of smoking women was 74.0 pg/mg creatinine, and for her newborn 78.6 pg/mg creatinine. Among mothers exposed to SHS, cotinine and NNAL mean concentration were 23.1 ng/mg creatinine, and 26.4 pg/mg creatinine. In newborns of SHS exposed mothers during pregnancy the mean concentration of NNAL was 34.1 pg/mg creatinine, respectively. Active tobacco smoking as well as passive exposure to smoking during pregnancy is an important source of tobacco specific N-nitrosamines to the fetuses as evidenced by increased concentrations of this carcinogen. Determination of NNAL in maternal urine samples can be a useful biomarker of prenatal exposure of newborn to carcinogenic nitrosamines.

Maternal reproductive history and the risk of isolated congenital malformations.

We examined the relationship between maternal reproductive history and the newborn's risk of isolated congenital malformations in a large case-control cohort from the Polish Registry of Congenital Malformations. Congenital malformations were classified into four categories: isolated congenital heart defects (n=1673), isolated cleft palate (n=255), cleft lip with or without cleft palate (n=448) and renal agenesis (n=103). The case groups were compared with a shared group of 2068 controls recruited in the same time period and geographic area. Multivariable logistic regression was used to assess the risk associated with maternal gravidity and of previous miscarriages after accounting for maternal age and other potential risk factors. In unadjusted analyses, maternal gravidity was significantly associated with increased risk of all four classes of congenital malformations. After adjustment, a significant association persisted for congenital heart defects [odds ratio (OR)=1.22, [95% confidence interval (CI) 1.09, 1.36], P=0.0007] and cleft lip with or without cleft palate (OR=1.21, [95% CI 1.09, 1.36], P=0.0005). A similar trend existed for isolated cleft palate (OR=1.18, [95% CI 1.02, 1.37], P=0.03). There was no appreciable increase in the risk of congenital malformations associated with a maternal history of miscarriages, but a trend for a protective effect on the occurrence of cleft lip with or without cleft palate was observed (OR=0.72, [95% CI 0.52, 0.99], P=0.045). Based on our data, maternal gravidity represents a significant risk factor for congenital heart defects and cleft lip with or without cleft palate in the newborn infant. Our data do not support an increase in risk because of past history of miscarriages.

[Selected ethical problems in neonatology -- opinions of physicians and nurses based on questionnaire study]. / Wybrane problemy etyczne w neonatologii -- poglady lekarzy i pielegniarek na podstawie badan ankietowych.

UNLABELLED: AIM OF THIS PAPER: To present the opinions of doctors and nurses on the limitations of resuscitation and treatment of extremely premature newborns. MATERIAL AND METHODS: Anonymous questionnaire studies were carried out in 342 doctors and 1194 nurses from 6 provinces of Poland. The authors compared the answers of doctors and nurses as well as the answers form different provinces. The results were processed using the Chi2 test, with the significance level p<0.05. RESULTS: The will to resuscitate the neonate, regardless of its birth weight was declared by 29% of the physicians and 49% of the nurses, regardless of the gestational age - by 21% of the physicians and 47% of the nurses. Resuscitation of an extremely immature, asphyctic newborn was declared by 71% of the physicians and 59% of the nurses. Limitation of therapy after diagnosing severe intracranial hemorrhage is declared by 67% of the physicians and 45% of the nurses. 37% of the doctors and 30% of the nurses would comply with parents' will when deciding about resuscitation. 44% of the physicians and 31% of the nurses declare taking parents' decision into account in the matter of abandoning resuscitation. CONCLUSIONS: 1. There is a higher percentage of persons convinced about the necessity of resuscitation of every newborn, regardless of its maturity, among the nurses than among the doctors. 2. Among the nurses there are more persons, who are sceptical about saving the extremely premature newborns born with asphyxia, whereas among the doctors there are more persons inclined to stop therapy in case of a severe intracranial hemorrhage. 3. The most controversial are problems concerning the consideration of parents' will in decision about whether to continue or abandon resuscitation, but physicians are more apt to regard parents' will in resuscitation in some situations. 4. The analysis of the questionnaire points to the need for deeper knowledge of the present mortality rates of the extremely immature newborns and further development of the surviving ones among the physicians and nurses.

[Newborn of a mother with HELLP syndrome]. / Noworodek matki z zespolem HELLP.

HELLP syndrome is a serious complication of pregnancy with characteristic appearances between 22 to 26 weeks of gestation. Clinical classification in three groups, is based on platelet count. Early diagnosis and appropriate management allow women to achieve a mortality rate below 1%. Neonatal complications are strongly associated with a newborn's immaturity and class of HELLP syndrome. In both presented cases despite identical maternal treatment (steroids because of I st class of HELLP syndrome) neonatal clinical courses were different due to the differences in gestational age. However, appropriate prenatal and neonatal care in tertiary centers was successful.

[Tissue and blood oxygenation in newborns < 1250g and incidence of ROP]. / Stopien utlenowania krwi noworodków z masa ciala < 1250 g a czestosc retinopatii.

AIM: The aim of this study was to analyze correlations between the onset and severity of retinopathy and premature birth. MATERIAL AND METHODS: In the three groups of 30 newborns < 1250 g we have analyzed blood saturation, tissue oxygenation and blood transfusion. To estimate tissue oxygenation we used following formulas; 1. TVCE = [formula: see text] V-blood volume = 8% of body weight 2. Oxygen availability = (0.54 + 0.005 x gestational age) x Hb (g/dL) Additionally we investigated incidence of BPD, PDA, severe IVH, and sepsis. RESULTS: We have found statistically significant influence of drops of SaO2 < 85% and lower mean values of SaO2 on development of severe retinopathy. We have not seen any statistical differences in the other parameters of oxygenation between the groups. CONCLUSIONS: Fluctuation as well as instability of oxygen blood saturation seem to be the most important risk factors of retinopathy. Limitation of early blood transfusions can decrease incidence of ROP. We do not have adequate methods for the estimation of tissue oxygenation which can be used to verify indications for blood transfusion. We should use very restrictive recommendations for blood transfusion in ELBW babies.

Phentolamine administration increases blood S100B protein levels in pediatric open-heart surgery patients.

AIM: Phentolamine administration during open-heart surgery shortens the cooling and rewarming phases of cardiopulmonary bypass (CPB) and hastens weaning from mechanical ventilation and extubation. Data on the effects of phentolamine on cerebral circulation and function in this setting are lacking. This study reports the cerebral effects of phentolamine using blood S100B protein levels and the middle cerebral artery pulsatility index (MCA PI). METHODS: Sixty pediatric patients undergoing congenital heart disease repair were randomly assigned to receive either phentolamine 0.2 mg kg(-1) i.v. (n = 30) or placebo (n = 30) before the cooling and rewarming phases of CPB. Samples for S100B measurement were collected at seven predetermined time-points before, during and after surgery. MCA PI values were recorded at the same times as sampling. RESULTS: S100B blood levels were higher in the phentolamine-treated group than in controls after rewarming (3.53 +/- 1.88 vs 1.58 +/- 0.53 microg l(-1); p < 0.001), remained persistently higher at the end of surgery (2.95 +/- 0.91 vs 0.79 +/- 0.21 microg l(-1); p < 0.001) and returned to normal ranges 12 h later than in the placebo group (p > 0.05). MCA PI values were also significantly higher at the end of surgery in the phentolamine-treated group (1.83 +/- 0.50 vs 1.22 +/- 0.34; p < 0.01). Cooling and rewarming times were shorter in the phentolamine-treated group (p < 0.01, for all). CONCLUSION: Despite improved peripheral vasodilatation and perfusion, phentolamine administration in pediatric open-heart surgery is correlated with increased cerebrovascular resistance and brain damage.

[Magnesium sulphate in the treatment of ischemic-hypoxic neonatal encephalopathy]. / Siarczan magnezu w leczeniu encefalopatii niedokrwienno-niedotlenieniowej u noworodka.

Hypoxic-ischaemic encephalopathy (HIE) remains one of the most important neurological complications in full and near full term newborns. During HIE glutamate and other excitatory neurotransmitters are released and progressive energy failure in brain is observed. Toxicity of glutamate plays the main role in brain injury. Glutamate activates the specific receptors that, in turn, mediate an overwhelming influx of calcium into the postsynaptic neuron. The pathological changes are located particularly in hippocampus. Magnesium sulfate has been used safely for years to treat preclampsia. The animal experimental evidence support a neuroprotective role for magnesium in HIE.

Histologic evaluation of the atrioventricular nodal artery in healthy humans and in patients with conduction disturbances.

The anatomy of the conduction system of the heart so relevant in the contemporary invasive cardiology is not fully understood. It has turned out that ablation procedures bring new information as to its structure and function, but in some cases can result in complete a-v block. Atrioventricular nodal artery located within the nodal-perinodal tissue can probably be damaged during the ablation procedures. Therefore, we decided to explore in detail the morphology and the topography of the atrioventricular nodal artery in healthy humans and in patients with clinical traits of a-v conduction disturbances requiring permanent pacing. The microscopic study was carried out on 30 normal human hearts specimens (17 F, 3 M) from 17 to 86 years of age, and on 20 hearts with conduction disturbances (11 F, 9 M) from 39 to 85 years of age. We found that the number of the atrioventricular node arteries is different and independent of the extent that induces block causing conduction disturbances. The topography of the artery in perinodal zone was consistent in normal hearts, yet in hearts with conduction disturbances we observed about 2% of deviations in its location. It might be the reason for generation of iatrogenic complications after invasive cardiological procedures. The morphology revealed changes in 50% of the examined hearts and their vessel walls, which was declared to be connected with ageing. This correlated with certain stages of atherosclerosis as well as hypertension characteristic of elderly patients. We observed that in 33% of hearts from control group small parietal thrombi were detected and in 60% of paced group respectively. Hence, it seems that the procedures in perinodal zone should be performed in its proximal part because of a minor probability of direct and indirect (through nodal artery) damage of the atrioventricular structure of the junction.

The morphological conditions of the permanent pacemaker lead extraction.

Pacemaker lead extraction is the treatment of choice in infectious complications regarding implantation procedure. The purpose of this study was to estimate the safety of the extraction in relation to the morphological changes of the pacing electrode. Research was carried out on materials consisting of 60 human hearts from 45 to 95 years of age (average 63 +/- 15 yrs), with VVI or DDD pacing (pacing duration 84 +/- 26 months) fixed in a formalin solution. Classical macroscopic anatomical methods were applied. In 44 hearts (73.3%) from the investigated group the posterior tricuspid leaflet was thickened only, and in 24 of these hearts the process regarded not only posterior leaflet but also the septal one and especially commissure between them. In 52 hearts (86.6%) inflammatory reaction spread also to the neighbouring part of the electrode. The length of the neointima-inflammatory tissue ranged from 4 to 8 mm (average 5 +/- 2 mm). On the tip of the electrode in the right ventricle cavity in 56 hearts (93.3%) we observed that endocardial leads were surrounded by fibrous thickening, and partially covered by endocardial tissue. We concluded that from the anatomical point of view the extraction of the pacing electrode seems to be questionable, especially in long-term permanent pacing. The experimental traction shows that only recently implanted electrodes were removed without any complications and in others with fraction of the tip, myocardial tissue avulsion or such removal was not successful at all.

Renal blood flow in twins.

The aim of this preliminary study was the estimation of renal blood flow in 16 premature newborns from twin pregnancies with mean body weight 1270 g and mean gestational age 29 weeks. In control group we have 16 singleton newborns with mean gestational age 29 weeks and mean birth weight 1240 g. In both intervention and control group we have the similar clinical symptoms. The renal blood flow was carried out in the first day of life with the Acuson 128 XP Colour Doppler using the 6 and 7 MHz linear transducer. The renal blood flow parameters-PI, RI, Vmax, Vmin Vmean were measured in right and left renal arteries in theirs courses from the aorta to the renal hilus, by color sinal. In the investigation group the mean value of RI in right and left renal artery was 0.88. Mean PI in right vessel was 1.67 and in left 1.56. Mean V min in right and in left artery was 0.03 and mean V max in right artery was 0.34 and in left 0.33. Mean value of mean velocity in right vessels was 0.18 and in left 0.19. In control group we observed in right artery mean value of PI 1.74 and in left 1.6. Mean RI was 0.86 and 0.86 in right vessel in left vessel. Mean V min was 0.05 in right and 0.04 in left artery. Mean V max was 0.37 in right and 0.34 in left artery. Mean value of V mean was 0.19 in right artery and 0.18 in left artery. Using the student, Mann-Whitney and Shapiro-Wilk tests we have not observed statistically significant difference of Doppler parameters between control and investigation group and between the left and right artery. Although in newborns with broad PDA we noted significant higher value of RI (0.97, 0.98) than in newborns without PDA (0.78, 0.81).

[Hematocrit values in newborns with intraventricular hemorrhage, periventricular hemorrhage and periventricular leukomalacia]. / Wartosci hematokrytu u noworodków z krwawieniami dokomorowymi i okolokomorowymi oraz zmianami leukomalacyjnymi mózgu.

The group of one hundred newborns with a birth weight from 650 to 3340 g, born between 24 and 41 week of pregnancy had been assessed according to the interdependence between hematocrit and intraventricular haemorrhage (IVH) and periventricular leukomalacia (PVL). The data indicate that among etiological factors which have the influence on prevalence and intensification of IVH and PVL there should be taken into consideration abnormal values of venous haematocrit in first hours of life. Newborns with moderate and severe degree of IVH and with PVL have abnormal values of haematocrit in first hours of life in 50-60%. In etiology of IVH and PVL greater importance have decreased than increased values of haematocrit.

[Incidence and antibiotic resistance of coagulase-negative staphylococci in a neonatal intensive are unit]. / Wystepowanie oraz antybiotykoopornosc gronkowców koagulazo-ujemnych w Oddziale Intensywnej Terapii Noworodka.

Coagulase-negative Staphylococci (CNST) are among the most common microorganisms found colonizing the skin and mucous membranes of neonates. They are also the most common cause of bacteremia in neonatal intensive care units. We analyzed the occurrence of CNST and antibiotic resistance of CNST strains. We have found 731 strains of CNST isolated from 428 intensive treated babies. Above 50% of CNST strains were resistant to: Erythromycin, Lincomycin, Tobramycin, Gentamycin, Kanamycin, Tetracyclines and Penicillins. We have observed the very high incidence of multiresistant strains. Majority of our strains were sensitive to vancomycin. However 8% of strains showed the resistance to vancomycin.