J Korean Soc Neonatol.  2009 Nov;16(2):172-181.

Causative Agents and Antimicrobial Sensitivity of Neonatal Sepsis: Ten-year Experience in One Neonatal Intensive Care Unit

• Park HW
• Lim G
• Koo SE
• Lee BS
• Kim KS
• Pi SY
• Kim AR

Abstract

PURPOSE
To identify trends in causative bacterial organisms for neonatal sepsis and antimicrobial susceptibilities over 10 years in one neonatal intensive care unit.
METHODS
We retrospectively reviewed the cases of culture-proven neonatal sepsis between January 1998 and December 2007. The 10-year period was divided into two phases (phase I, 1998-2002; phase II, 2003-2007) to distinguish the differences during the entire period.
RESULTS
Total 350 episodes of neonatal sepsis were identified in 315 neonates. The common pathogens of early-onset sepsis were S. epidermidis, S. aureus, P. aeruginosa, and E. cloacae in phase I, and S. epidermidis and E. cloacae in phase II. In cases of late- onset sepsis, coagulase negative Staphylococcus, S. aureus, and K. pneumoniae were isolated frequently in both phases. The incidence of sepsis caused by multi-drug resistant organisms decreased with strict infection control. Gram positive organisms showed 0-20% susceptibility to penicillin, ampicillin, and cefotaxime in both phases. Sensitivity to amikacin for Enterobacter spp. increased, whereas P. aeruginosa showed decreased sensitivity in phase II. Between 50% and 60% of other gram negative bacteria, except P. aeruginosa, were susceptible to cefotaxime in phase II in contrast to phase I. Greater than 80% of gram negative bacteria were sensitive to imipenem except P. aeruginosa and ciprofloxacin in both phases.
CONCLUSION
The trend in causative microorganisms and antimicrobial susceptibilities can be used as a guideline for selection of appropriate antibiotics. A particular attention should be paid to infection control, especially to reduce sepsis caused by multi-drug resistant organisms.

Keyword

Neonatal sepsis; Causative organism; Antibiotic susceptibility

MeSH Terms

Amikacin
Ampicillin
Anti-Bacterial Agents
Cefotaxime
Ciprofloxacin
Cloaca
Coagulase
Enterobacter
Gram-Negative Bacteria
Humans
Imipenem
Incidence
Infant, Newborn
Infection Control
Intensive Care, Neonatal
Penicillins
Pneumonia
Retrospective Studies
Sepsis
Staphylococcus
Amikacin
Ampicillin
Anti-Bacterial Agents
Cefotaxime
Ciprofloxacin
Coagulase
Imipenem
Penicillins