Incidence of colonization of preterm neonates’ gastric aspirate and its correlation with neonatal, maternal and environmental risk factors

Abstract

Background: Infants born with Very Low Birth Weight (< 1500 grams) and Extremely Low Birth Weight (< 1000 grams) are at a high risk of pre-discharge morbidities. Aim of our study was to know the incidence of colonization of the preterm neonates’ gastric aspirate and to co-relate it with the various neonatal, maternal and environmental risk factors.

Material and Methods: This was a prospective, observational study in 100 neonates conducted over a period of two years at Pediatrics Department of a teaching hospital of Western Gujarat region. All pre-term newborns who did not have any clinical features for sepsis were included in the study.

Results: In our study, most common organisms isolated were enterococcus (41%) followed by bacteroids (26%) and staphylococcus (14%) in 24 hours & 72 hours of gastric aspirate sample. Lower gestation age and low birth weight were significantly associated with colonization of the preterm neonatal gut (p<0.05). The positive colonization was also significantly correlated to low APGAR score. Highest incidence of neonatal sepsis was seen with enterococci organism (14.6%), where six newborns with enterococci isolates in gastric aspirate had developed neonatal sepsis, followed by E. coli isolates (12.5%).

Conclusions: We found a high incidence of colonization of the preterm neonates’ gut, with enterococcus being the most common isolate. A significant association was observed between gut colonization and development of neonatal sepsis. Significant factors for development of gut colonization were: lower gestation age, multiple per-vaginal examinations and low birth weight of the newborns.