Evaluation of our neonatal sepsis cases in terms of causing microorganism and antibiotic resistance

Abstract

Objective: The purpose of the study is to evaluate sepsis cases in Neonatal Intensive Care Unit (NICU) in terms of the causative microorganisms and antibiotic resistance. Material and Methods: We retrospectively reviewed 115 patients who had been diagnosed with clinical sepsis and proven sepsis at the NICU between 01.01.2013 and 30.09.2014. Patients were classified as early (0-3 days), late (3-30 days), and very late (> 30 days) sepsis. Results: A total of 721 patients were admitted to our hospital during the study period. 11,1% (n= 80) were diagnosed with proven sepsis, and 7.6% (n= 55) were diagnosed with clinical sepsis. Early sepsis (ES), late sepsis (LS), and very late sepsis (VLS) were found to be 37%, 54.8% and 8.15%, respectively. Coagulase-negative Staphylococcus (CNS) was the most common etiologic factor in all sepsis groups. The mortality rate of Klebsiella spp. (Klebsiella pneumoniae 50%, Klebsiella oxytoca 40%) were found to be the highest. A decrease in sepsis-related mortality rate from 21.5% to 12.5% and a decrease in rate of K. pneumoniae (25% to 8.3%) was found in 2014 compared with 2013. In general, sensitivity of ampicillin and gentamicin was very low (0-18%, 23-50%, respectively). An increase in vancomycin and teicoplanin resistance (3-11%, 3-5.5%) among gram-positive microorganisms and an increase in amikacin resistance (59-83%) among gram negative microorganisms in 2014 compared with 2013 were observed. Conclusion: Close follow-up of the patient’s clinic and culture results and use of microorganism specific narrow spectrum antibiotics and compliance with infection control practices will reduce resistance rates. Each unit should determine treatment management according to its own culture results.