Nosocomial infection is a common problem in the Neonatal Intensive Care Unit (NICU) and a knowledge of the pattern of nosocomial infection will contribute greatly to the intensification of infection control measures and the development of antibiotic policies in the NICU. This study aims to compare the incidence and clinical characteristics of neonates with nosocomial infection in NICU of both Kuala Terengganu Hospital (HKT) and Universiti Sains Malaysia Hospital (HUSM). Neonates who had both clinical signs of sepsis and positive blood cultures, 48 hours after admission to NICU, from 1(st) January to 31(st) December 1998, in both hospitals were retrospectively studied. Among neonates admitted to NICU, 30 (5.4%) in HKT and 65 (3.6%) in HUSM had nosocomial infection (p = 0.07). The mean duration of hospitalisation was shorter (HUSM 37 days, HKT 49 days; p = 0.02), and the number of neonates with predisposing factors for infection is higher (HUSM 100%, HKT 73.3%; p < 0.001) in HUSM compared with HKT. There were no differences in gestation, mean age of onset of infection and mortality between both hospitals. The most common organism isolated from the blood in HKT was Klebsiella pneumoniae (33.3%), and in HUSM Klebsiella aerogenes (24.6%). Half of Klebsiella pneumoniae isolates were resistant to cephalosporins and aminoglycosides in HKT and a similar number of Klebsiella aerogenes isolates were resistant to piperacillin and aminoglycosides in HUSM. In conclusion nosocomial infection is a common problem in both hospitals. Except for more frequent predisposing factors for infection in HUSM, and a longer duration of hospital stay among neonates in HKT, the clinical characteristics of neonates with nosocomial infection in both hospitals were similar.
Besides adenovirus, pneumonia can also be caused by bacteria. One of the most common bacteria causing the pneumonia is Klebsiella pneumoniae. Currently, treatment by antibiotics has been widely used. Nevertheless, the increasing failure of existing antibiotics because of antibiotic resistance resulted by bacterial pathogens has become a serious problem to human health. Hence, there is a need for a new antibacterial potential agent against K. pneumoniae as an alternative treatment to the pneumonia to prevent the risk of a severe pneumonia for both healthy people and those already infected with the pneumonia. This study, therefore, investigated the antibacterial activity of some selected plants (Pandanus tectorius, Nypa fruticans, Sonneratia alba, Phaleria macrocarpa, Hibiscus tiliaceus, and Pongamia pinnata) against K. pneumoniae. In this study, samples were extracted successively by cold maceration using hexane and methanol. Antibacterial activity was determined by well and disc diffusion methods. Each fraction was prepared by two-fold dilutions from 20 mg/mL to 0.156 mg/mL. All data were analyzed in triplicate replication and presented as mean values ± standard deviation. Results showed that all methanol fractions of selected plants had antibacterial activity against K. pneumoniae, and well-diffusion method showed better antibacterial results compared to the agar well-diffusion method. The strongest activity was obtained by methanol fraction of S. alba leaf, followed by P. pinnata leaf, Nypa fruticans bark, H. tiliaceus leaf, P. macrocarpa leaf, and P. tectorius leaf with the minimum inhibitory concentrations (MICs) value between 0.625 and 5.0 mg/mL. Phytochemical screening revealed that all methanol fractions were rich in flavonoid content, which could have contributed to their antibacterial activity.