Page 287 - Abstract Book KONIKA 18

Neonatology

P-NEO-004
Serratia marcescens Infection in Preterm Neonate
with Bronchopulmonary Dysplasia

Andreas Budi Wijaya, Pudji Andayani, Pricillia Gunawan Halim, Ari Yunanto
Department of Pediatrics of Ulin General Hospital, Faculty of Medicine, Universitas Lambung Mangkurat,
Banjarmasin, South Borneno, Indonesia

Abstract
Background Serratia marcescensis an emerging cause of preterm neonatal sepsis, and associated with
neonatal pneumonia. The use of mechanical ventilator is also considered to be risk factor for S.marcescens
infection. Ventilator-induced trauma and in-utero inflammation, are closely related to the development of
bronchopulmonary dysplasia (BPD). Objective To describe the case of S.marcescens infection in preterm
neonate with bronchopulmonary dysplasia. Case A boy was born at gestational age of 34 weeks with birth
weight of 1075 g. The mother was admitted due to suspicion of premature rupture of membrane, but no
data about the etiology of precipitating infection. Treatment with corticosteroid for lung maturation was not
administered. The birth was spontaneous vaginal delivery (APGAR score 2/1 and 5/5). Examination revealed
severe dyspnea with grunting respiration, tachypnea, and crackles in the lung fields. Chest X-ray showed
infiltrate in both lungs, right and left lower zone. Echocardiography was however normal. Blood culture
examination showed positive result for S.marcescens infection. He was nursed in the incubator for 2 months,
and successively managed with intermittent oxygen, hydrocortisone for 22 days, antibiotic ceftazidime for
14 days. Mechanical ventilation was used for 10 days, before changed to non-invasive positive-pressure
ventilation. He responded well to treatment and was discharged home without any oxygen therapy. The
weight on discharge was 1500 g. Conclusion S.marcescens infection might be transmitted from mother or
nosocomially from hospital environment. Infection exposure in-utero might be causally related to preterm
delivery and subsequent lung injury. However, the exact role of infection in BPS has still been debatable.
Keywords: Serratia marcescens; preterm; bronchopulmonary dysplasia

P-NEO-005
Klebsiella pneumoniae Infection at Neonatal Intensive Care Unit:
A Descriptive Study

Abia Nebula, Yenny Purnama, Yenny Kumalawati, Wisvici Yosua, Windhi Kresnawati
Departemen of Child Health, Gatot Soebroto National Army Hospital, Jakarta, Indonesia

Abstract
Background Klebsiella pneumoniae (KP) has a significant role in increasing morbidity, mortality, length of
stay and health cost. Gatot Soebroto Hospital documented that KP infection contributed in 25,5% mortality
in Neonatal Intensive Care Unit (NICU). We want to evaluate the characteristic patients with KP infection.
Objective To describe characteristic and clinical manifestation KP infection in neonates. Methods A descriptive
retrospective study was conducted on neonates with KP infection at NICU Gatot Soebroto Hospital in 2018-
2020. Results We reported 70 KP infection cases (in 2018-2020) with 42 male neonates (60%), 38 preemies
(54%) and 44 low birth weight babies (62%). All subjects have received multiple and broad spectrum
Antibiotics. Eleven subjects (15%) have been treated with Carbapenem before KP infection occurred.
Carbapenem resistance (KPC) were found in 36 (58%) subjects. Most subjects (n=50;71%) had undergone
abdominal surgery prior to KP infection. Clinical manifestations of KP infection were hypoglycemia (92%),
anemia (70%), thrombocytopenia (44.62%), respiratory failure (34%), hypoalbuminemia (28%), leucopenia
(21%) and leucosytosis (18%). Conclusion Most of neonates that had KP infection were preterm or low birth
weight. Most of them had history of multiple broad spectrum Antibiotics treatment, and experienced abdominal
surgery prior to KP infection. The predominant signs were hypoglycemia, anemia and thrombocytopenia.
However, the risk factor of KP infection is yet to be determined, further study is needed to indentify the
common risk factors of KP infection in neonates.
Keywords: Klebsiella pneumoniae; infection; neonates

KONIKA XVIII Abstract Book 239