A STUDY OF PRE-ANTIBIOTIC BACTERIOLOGY IN 125 PATIENTS WITH NECROTIZING ENTEROCOLITIS

Over a five-year period, 125 newborns with necrotizing enterocolitis ( NEC) were managed by us. Their mean birthweight was 1700 g and mean ma turity was 32 weeks. Before commencement of antibiotics, routine septi c work-up was done in order to define the bacterial spectrum and antib iotic sensitivity. The study includes aerobic and anaerobic cultures o f gastric and pharyngeal aspirates, blood cultures, umbilical swabs an d culture of umbilical catheter tips in relevant cases. Peritoneal swa b results were also analyzed if laparotomy was performed. Positive cul tures were present in 45 patients (36%) with 55 positive specimens. Fi fteen types of organism were isolated: the commonest was Enterobacter (29%), followed by E. coli (14.5%) and Klebsiella (13%). They were res istant to ampicillin and first-generation cephalosporin. These organis ms were usually opportunistic pathogens. Overgrowth of them may be the cause of NEC. Regular review of the antibiotic sensitivity of these o rganisms allows prompt and appropriate choice of antibiotics. At the s ame time, antibiotic sensitivity for these organisms was analyzed to g uide us in the choice of antibiotic therapy.