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Causative Agents, Antibiotic Resistance Patterns and Risk Factors in Early and Late Onset Neonatal Sepsis in a Neonatal Intensive Care Unit |
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Address : Dr. Nadire Seval Gündem, Dr Ali Kemal Belviranl Gynecology, Obstetrics and Children Hospital, Yeni Stanbul Street, Konya, Selçuklu-42285, Turkey, Konya, Turkey. E-mail: sevalgndem@yahoo.com |
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Introduction: Neonatal sepsis is one of the major causes of neonatal mortality. Causative agents, antibiotic resistance patterns and risk factors of sepsis differ from one region to another in the world. Periodic assessments of these will guide to use an appropriate antibiotics for rational empirical treatment and contribute to management of sepsis. Aim: To determine causative agents, antibiotic resistance patterns and risk factors of early and late onset neonatal sepsis. Materials and Methods: A total of 230 neonates diagnosed as sepsis were included in this retrospective study. Data collection was made by reviewing records of patients from laboratory and hospital information system of Konya Dr Ali Kemal Belviranli Gynaecology, Obstetrics and Children Hospital between September 2015-May 2017. Blood samples were incubated in automated blood culture system. Subcultures were performed on 5% sheep blood agar and eosin methylene blue agar. Identification of microorganisms was firstly made by conventional methods. Further identification and antibiotic susceptibility tests were performed by automatic analyser. Results were considered statistically significant at p<0.05. Results: Early Onset Sepsis (EOS) was detected in 19 (8.3%) neonates while Late Onset Sepsis (LOS) occured in 211 (91.7%) of them. Coagulase-negative Staphylococcus was the most commonly isolated microorganisms in both early and late onset sepsis with rates of 84.2% and 81.5%, respectively. The rate of gram negative microorganisms was 13% and Enterobacteriaceae compose 8.7% of these. Klebsiella pneumoniae (3.5%) was the most common bacteria within Enterobacteriaceae. High methicillin resistance rates (81.2% and 83.7%) were observed in Coagulase negative Staphylococcus in both EOS and LOS, respectively. Enterobacteriaceae had extended spectrum beta-lactamase positivity rate of 63.2% and showed high resistance to ceftriaxone (63.2%) and cefuroxime (78.9%). No carbapenem resistance were detected in gram negative bacteria. No significant associations was found between onset of sepsis and gestational age, gender and mode of delivery (p>0.05). Conclusion: There were some differences and also similarities between aetiologic agents and antibiotic resistance patterns among data obtained in this study and those from other countries. This study contributed to epidemiological information and routine antibiotic surveillance to use appropriate antibiotics for empirical treatment of sepsis and prevent its complications. |
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