Retrospective evaluation of culture-proven neonatal sepsis cases in neonatal intensive care unit

Objective: Neonatal sepsis is one of the most frequent and life threatening disorder in the fisrt 28 days of life. Although appropriate antibiotic treatment is performed, disease courses with high morbidity and mortality. The type of the causative organisms and their frequency may change by the time even in the same hospital. In this study, we aimed to evaluate characteristics of the culture-proven cases in our neonatal intensive care unit. Materials and Methods: Between January 2012–July 2015, 1735 neonates who were hospitalized at level 1,2 and 3 of neonatal intensive care unit at Bezm-i Alem Vakıf University Hospital. The 56 patients diagnosed as culture proven sepsis were involved in the study. Results: The mean gestational age of patients was 31,77 ±5 weeks, and the mean birth weight was 1654,07 ±906,6 grams. 55,4% of the patients were male, 44,6% of them were female. The patients were 76,8% premature and 23,2% term newborns. Early onset neonatal sepsis was diagnosed %14,3% of patients, late onset neonatal sepsis was diagnosed 85,7% of patients. Stenotrophomonas maltophilia was the most frequently isolated microorganism in patients with early onset neonatal sepsis, while coagulase-negative staphylococci and Klebsiella pneumoniae were the most frequently isolated microorganisms in patients diagnosed with late onset neonatal sepsis. Mortality rate was 12,5% in early onset neonatal sepsis, 12,5% in late onset neonatal sepsis. All of the babies were premature in both sepsis groups. Vancomycin resistance was not determined in any of the gram positive microorganisms. Meropenem resistance was not determined and imipenem had a maximum value of 50% resistance in the evaluated gram negative microorganisms. Conclusion: The type of sepsis and microorganisms and their antibiotic resistance changes amongst neonatal intensive care units and also in the same unit by the time. Active surveillance is recommended to update the treatment protocols. Key words: Sepsis, Newborn, Prematurity, Blood Culture, Antibiotic Resistance