Korean J Pediatr.  2006 Jun;49(6):623-629. 10.3345/kjp.2006.49.6.623.

Analysis of causative microorganisms and choice of antibiotics according to the onset of neonatal sepsis

• Sung JS
• Kim DY
• Kim SH
• Byun HS
• Hwang TJ
• Choi YY

• KMID: 2279882
• DOI: http://doi.org/10.3345/kjp.2006.49.6.623

Abstract

PURPOSE: The mortality rate of neonatal sepsis has been decreased, however, the incidence has not significantly decreased because of increased invasive procedures. This study was designed to make guidelines for choosing antibiotics by analyzing the causative microorganisms and their antibiotics sensitivity test according to the onset of neonatal sepsis.
METHODS
One hundred seven cases of culture proven sepsis in 89 patients admitted to the NICU of Chonnam University Hospital from Jan. 2000 to Dec. 2004, were enrolled. By reviewing the medical records, clinical data, laboratory findings, causative organisms and their antibiotics sensitivity, and mortality were analyzed.
RESULTS
The incidence of neonatal sepsis was 1.7 percent and more prevalent in premature and low birth weight infants. 85.4 percent of neonatal sepsis was late onset. Almost all microorganisms(92.9 percent) were gram-positive in early onset, however, two thirds were gram-positive and one third were gram-negative and Candida in late onset. Gram-negative organisms and Candida were more prevalent in patients who had central line. Gram-positive organisms were sensitive to vancomycin, teicoplanin, and gram-negative were sensitive to imipenem, and cefotaxime.
CONCLUSION
Neonatal sepsis was more prevalent in premature and low birth weight infants. More than 90 percent were gram-positive in early onset, however, one third was gram-negative and Candida in late onset. The first choice of antibiotics were a combination of third generation cephalosporin and clindamycin in early onset, and third generation cephalosporin and glycopeptide in late onset. If there is no response to antibiotics treatment, the use of antifungal agents should be considered.

Keyword

Neonatal sepsis; Early; Late; Antibiotics

MeSH Terms

Anti-Bacterial Agents*
Antifungal Agents
Candida
Cefotaxime
Clindamycin
Humans
Imipenem
Incidence
Infant
Infant, Low Birth Weight
Infant, Newborn
Jeollanam-do
Medical Records
Mortality
Sepsis*
Teicoplanin
Vancomycin
Anti-Bacterial Agents
Antifungal Agents
Cefotaxime
Clindamycin
Imipenem
Teicoplanin
Vancomycin