Evaluation of newborn intensive care unit results blood cultures

Introduction and Purpose: Neonatal sepsis is a major cause of morbidity and mortality in neonates. Sepsis agents and antibiotic susceptibilities of intensive care unit of newborns (NICU) change by time, dependent to the used antibiotics. In our study, culture antibiogram results, risk ractors, antibiotiotic resistance, routin laboratory parameters and prognosis of microorganisms were evaluated. Materials and Methods: Among 904 patients, who had admitted to NICU of our hospital with any reason or infection suspicion and blood culture had taken, 206 cases with reproduction in blood culture have included for this study between January 2011-December 2013. Diagnosis, gender, pregnancy week, birth weight, risk factors, laboratory results, early and late sepsis rates, distribution of propagated microorganisms through culture, antibiotic resistance and mortality of patients with positive blood culture were recorded. Findings: Culture positivity was found at 206 (%22,7) cases among 904 patients, whose blood culture was taken. %55,8 of those cases were male. Among those cases, %9,7 were ≤ 27 weeks old, % 58,6 were ≥ 37 weeks old, %9,2 were < 1000 gr and %59,5 > 2500 gr. Positive blood culture cases were evaluated as % 57,7 as early started sepsis, % 30,5 as lately started sepsis and % 11,6 as very lately started sepsis. Accompanied other diagnosis were found as % 37,4 respiratory distress syndrome, % 29,6 prematurity and % 27,7 jaundice. Postnatal risk factors were % 58,5 total parenteral nutrition, %54,2 length duration of hospitalization (> 15 days) and % 51,8 mechanic ventilation. Among the cases, It was found agents as % 58 gram (+), % 38 gram (-) and % 4 candida ,% 47,6 staphylococcus (composed of % 43,6 KNS), % 16 Klebsiella pneumoniae, % 10,7 Acenitobacter baumanni, % 4,9 Pseudomonas aeruginosa and % 4 Streptococcus. The most common antibiotics resistance were % 97,6 Penicilin-G, % 91 Ampiciline and % 78 Methicilline (MRSA) and The least common antibiotics resistance were % 0 Colistine, % 0 Teicoplanin and % 1,9 Vancomycin. Among gram (+) species, The most common antibiotics resistance were Amphiciline and Gentamicina and the least common antibiotics resistance were Teicoplanin, Linezolid and Vancomycin. Among gram (-) species The most common antibiotics resistance were Amphicilin, Gentamicin and Ceftriaxon and the most common antibiotics resistance were Meropenem, Amikacin and Cefoperazome/Sulbactam. Among the cases that were given mechanic ventilator support, have respiratory distress syndrome, prematures, hydrocephalus and have congenital cardiac disease, the most common agents were gram (-), whereas those agents were Klebsiella pneumoniae and Acinetobacter baumanni. Beside, Staphylococcus epidermidis was the most frequent among gram(+). Among 53 cases (% 25,7) that have Exitus, gram (-) were detected at 32 (% 15,4). Those were Acinetobacter baumanni (% 5,3), Klebsiella pneumoniae (% 5,3), Pseudomonas aeruginosa (% 1,9). It was observed that gram (+) were propagated at 21 cases (% 10,3). KNS varients were responsible from the huge part (% 9,2) of those, where the most frequently observed member was Staphylococcus epidermidis (% 5,3). Results: Gram negative sepsis agents have still continued to be most frequent and highest resitant frequency microorganisms in the present days. For this reason, we think that antibiotic selection due to flora of the NICU and antibiotic resitance of this microorganisms will increase the success of treatment and decrease the morbidity and mortality rate in newborns admitted to NICU with sepsis suspicion. Keywords: Neonatal sepsis, culture antibiogram, blood culture positive, antibiotic resistance