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. 2024 Jun 17;59(4):375-382.
doi: 10.5152/TurkArchPediatr.2024.24006.

Trends in Causative Organisms and Antimicrobial Resistance in Late-onset Neonatal Sepsis

Ayberk Özkavaklı  1 , Ebru Yalın İmamoğlu  2 , Neslihan Önder  3 , Serhat İmamoğlu  4 , Hüsnü Fahri Ovalı  2
Affiliations

Trends in Causative Organisms and Antimicrobial Resistance in Late-onset Neonatal Sepsis

Ayberk Özkavaklı et al. Turk Arch Pediatr. .

Abstract

The aim of this study was to evaluate the antibiotic resistance of microorganisms isolated in cases of culture-positive nosocomial late-onset neonatal sepsis in the neonatal intensive care unit. Infants admitted to our neonatal intensive care unit between October 2015 and June 2022 were retrospectively screened. A total of 458 different cultures from 386 sepsis incidents in 250 infants were analyzed. Over an 8-year period, 407 cases of culture-positive nosocomial late-onset neonatal sepsis were reviewed in a total of 4244 infants. Twenty-one cases were excluded due to insufficient data. The incidence of culture-positive nosocomial sepsis was 6.3%. Coagulase-negative Staphylococcus and Staphylococcus aureus were the most common gram-positive bacteria found in cultures. Resistance to ampicillin and cephalosporin treatments was high, while resistance to vancomycin, teicoplanin, and linezolid was low. Klebsiella spp. were the most frequent gram-negative bacteria isolated in cultures and showed high resistance to non-carbapenembased regimens. The only fungal microorganisms isolated in cultures were Candida spp., which had a high mortality rate despite their low resistance profile. The mortality rate due to nosocomial sepsis was 19.6%. Our study demonstrated that microorganisms and their antibiotic resistance profiles changed over time in the newborn intensive care unit. Gram-negative pathogens exhibited high antibiotic resistance, while fungi had high mortality rates. It is essential to adjust empirical antibiotic regimens for nosocomial sepsis based on thorough surveillance.

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Conflict of interest statement

Declaration of Interests: The authors declared that they have no conflict of interests.

Figures

Figure 1.
Figure 1.
A flowchart of the infants born in our hospital, hospitalized infants, and septic infants.
Figure 2.
Figure 2.
The rates of culture-positive hospital-acquired late-onset sepsis in neonates admitted to our unit according to gestational weeks.
Figure 3.
Figure 3.
Comparison of microorganisms isolated in cultures in 2-year periods.
Figure 4.
Figure 4.
Two-year comparison of positive cultures.
See this image and copyright information in PMC

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