Retrospective evaluation of the cases with neonatal sepsis and antibiotic resistance of the causing microorganisms

Objective: This study was performed to evaluate the demographical features, risk factors, responsible microorganisms, antibiotic resistance of newborns with sepsis in a neonatal intensive care unit (NICU).
Material and Method: A total of 121 patients who were diagnosed with sepsis between May 2014 and May 2015 in our NICU were evaluated retrospectively. The cases were investigated in terms of gender, birth weight, gestational age, risk factors, clinical and laboratory findings, cerebrospinal fluid (CSF) analysis and biochemistry, cultures of blood, urine and CSF, distribution of microorganisms, and antibiotic resistance.
Results: A total of 431 patients were admitted to NICU during the study period. Of these, 121 (28%) patients were diagnosed as neonatal sepsis. Early and late-onset sepsis were diagnosed in 85 (70.3%) and 36 (29.7%) cases respectively, and 24 (19.8%) cases were premature. At least one risk factor was identified in 60% of patients with sepsis. Bacterial growth was detected in 39 (32%) of total cultures. The most isolated microorganisms were S.aureus (30.2%), K.pneumoniae (25.5%) and S.epidermidis (16.2%).
Conclusions: The changing spectrum of etiology and increasing drug resistance in neonatal sepsis may pose a serious problem. Therefore, the risk factors, responsible microorganisms, and antibiotic resistance in neonatal sepsis must be determined for every NICU to start appropriate empirical antimicrobial therapy.

Neonatal sepsisli olgularýn retrospektif deðerlendirilmesi ve etkenlerin antibiyotik direnci

Amaç: Bu çalýþma yenidoðan servisinde tedavi gören sepsis tanýlý bebeklerin demografik özelliklerini, risk faktörlerini, etken mikroorganizmalarý ve antibiyotik dirençlerini saptamak amacý ile gerçekleþ- tirildi.
Gereç ve Yöntem: Hastanemiz yenidoðan yoðun bakým ünitesinde Mayýs 2014 ile Mayýs 2015 tarihleri arasýnda sepsis tanýsý ile yatan ve takip edilen 121 bebek retrospektif olarak deðerlendirildi. Olgular cinsiyet, doðum aðýrlýðý ve haftasý, risk faktörleri, klinik ve laboratuvar bulgularý, beyin omurilik sývýsý (BOS) biyokimyasý ile kan, BOS ve idrar kültürü, etken mikroorganizma ve antibiyotik direnci yönünden incelendi.
Bulgular: Çalýþma döneminde 431 bebek çeþitli tanýlarla yatýrýldý. Sepsis tanýsý alarak tedavi gören 121 (%28.0) bebek çalýþmaya dahil edildi.Olgularýn 36’sý (%29.7) geç sepsis, 85’i (%70.3) erken sepsis tanýsý almýþ olup, 24 olgu (%19.8) prematüre idi. Sepsis tanýsý konulan olgularýn %60’ýnda bir veya daha fazla risk faktörü mevcuttu. Toplam 39 (%32.0) kültürde üreme saptandý. Kültürlerde en sýk üreyen mikroorganizmalar S. aureus (%30.2), K. pneumoniae (%25.5) ve S. epidermidis (%16.2) idi.
Sonuçlar: Sepsis etkenlerinin deðiþmesi ve dirençli mikroorganizmalarýn giderek artmasý önemli bir sorundur. Bu nedenle her yenidoðan ünitesinde neonatal sepsis risk faktörlerinin, sýk görülen etkenlerin ve antibiyotik dirençlerinin saptanarak, bu verilere göre ampirik tedavi planýnýn yapýlmasý önem taþýmaktadýr.