Evaluation Of Proven Nosocomial Sepsis Agents In A Level III Neonatal Intensive Care Center: A 2- Year Analysis

Year 2004, Volume: 5 Issue: 2, 5 - 9, 01.08.2004

Mehmet Yalaz Sertaç Arslanoğlu Hasan Çetin Şöhret Aydemir Alper Tünger Mete Akisu Nilgün Kültürsay

Abstract

PURPOSE: Despite advances in supportive care and use of antibiotics, sepsis neonatorum preserves its importance due to its high mortality and morbidity. Identifying the causative agents and antibiotic resistance yearly in a neonatal intensive care unit (NICU) helps the physician to choose the most appropriate empirical therapy. In this study we aimed to evaluate positive blood cultures and antibiotic susceptibilities of newborns with proven sepsis in the years 2000-2001 in our NICU. MATERIALS-METHODS: The charts of hospitalized newborns between 2000-2001 were retrospectively studied. The causative agents and antibiotic susceptibilities in newborns with proven sepsis were evaluated. RESULTS: A total of 48 positive results were obtained in 44 newborns among 576 newborns in this time period. Although most of the admitted patients were preterm infants (86.7 %) the frequency of proven sepsis was low (7.6%). Mortality rate of septicemia was 15.9 %. The most commonly isolated microorganisms were Coagulase- negative Staphylococci (CNS) (27.1%), Candida spp. (18.8%), Staphylococcus aureus (14.6%), Enterobacter spp (14.6%). The antibiotic susceptibilities of microorganisms were as follows: For CNS: Teicoplanin and Vancomycin 100%, Gentamicin 54% for S. aureus: Teicoplanin and Vancomycin 100%, Clindamycin 72%, Gentamicin 57%, for Enterobacter spp.: Meropenem and Piperacillin-tazobactam 100%, quinolones 86%. Methicillin resistance was 100% for CNS and 72% for S.aureus. In the year 2001, a significant increase in the frequency of Enterobacter spp. (11-16.6%) and Candida spp. infections (5.5-26.7%) was observed compared to the previous year. CONCLUSION: We  concluded  that  initial  empirical  antibiotic  therapy  for  nosocomial  sepsis  withTeicoplanin+Piperacillin-tazobactam/Meropenem plus antifungal therapy (Fluconazole or Amphotericine B) may be the best combination until the culture results arrive.

Keywords

Newborn, sepsis, nosocomial, antibiotic, surveillance

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