Epidemiology of sepsis in neonates: Microbiological profile and antibiotic susceptibility Yenidoğan sepsis epidemiyolojisi: Etken dağılımı ve antibiyotik duyarlılıkları
Cocuk Enfeksiyon Dergisi, cilt.13, sa.4, 2019 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 13 Sayı: 4
- Basım Tarihi: 2019
- Doi Numarası: 10.5578/ced.68666
- Dergi Adı: Cocuk Enfeksiyon Dergisi
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Anahtar Kelimeler: Neonate, prematurity, early-onset sepsis, late-onset sepsis, antibiotic resistance
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Continuous surveillance is important to be informed on local epidemiology and cover organisms likely to cause sepsis in empirical therapy. We aimed to determine the characteristics of neonates with sepsis and etiological organisms in a single center. Material and Methods: This retrospective study included neonates admitted at level I-III units (NICU) in Kanuni Sultan Suleyman Training and Research Hospital during a one-year period (January 1st, 2010 to December 31st, 2010). The characteristics of neonates diagnosed as sepsis were compared to those without sepsis in order to determine risk factors. The distribution and resistance pattern of pathogens causing sepsis during 2010 were identified and compared with those of the previous years. Results: Among the 4703 patients treated in our NICU, 292 (6.2%) were diagnosed as culture proven sepsis [96 early-onset sepsis (EOS), 196 late-onset sepsis (LOS)]. Mean birth weight was 2304 ± 1066.9 g (640-5250 g) and mean gestational age was 36 ± 4.2 weeks (24-40 weeks). Preterm babies were infected four times more frequently than babies born at term [OR, 3.96 (95% CI, 3.10-5.06, p= 0.001)]. Presence of central venous catheter, ventilation support, total parenteral nutrition, and prolonged hospitalization were other risk factors for sepsis development. Mortality from EOS was higher than that from LOS (19.8% vs. 4.1%, p= 0.001). Coagulase negative staphylococci (CoNS) were the most commonly isolated pathogens in blood cultures of term neonates. Gram-negative bacilli [Klebsiella pneumoniae (18.4%), other GNB (27%)] were more common in preterm babies than term neonates. Resistance to penicillin and ampicillin were high in gram-positive bacteria. Ampicillin, gentamicin, cefotaxime, and carbapenem resistances in GNB were 63%, 36%, 33%, and 7.5%, respectively. Conclusion: Prematurity is a major risk factor for sepsis. During the years of 1997, 2005, 2007, and 2010, CoNS remained the most frequent pathogen. The relative proportion of gram-negative bacilli is substantial in preterm babies. Carbapenem resistance in GNB is worth consideration.