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Infections in newborn infants in a special care unit. A changing pattern of infection.

An analysis of infections in the intensive and intermediate care nurseries (special care unit) of the Hospital of the University of Pennsylvania was made over a three year period. From January 1982 to September 1984, 98 bacteremias were identified in 2571 infants, giving an overall incidence of 3.8 per 100 infants admitted to the special care unit and 11.8 per 1000 hospital births; 7 of 98 infants died, all from early onset disease. Fifty-eight percent of bacteremias were nosocomial. Gram positive organisms accounted for 89 percent of all bacteremias, with coagulase negative staphylococcus and beta hemolytic streptococcus Group B (GBS) being the most frequently identified organisms. Coagulase negative staphylococcus was responsible for 42 percent of bacteremias and 75 percent of all nosocomial infections during this period. Streptococcus Group B was responsible for 78 percent of early onset infection; mortality rate from GBS was 11 percent. In view of the changing pattern of infection and the predominance of coagulase negative staphylococcus, the therapy for nosocomial infection should include antibiotics effective against this organism.