Özet:

PURPOSE: Type and antibiotic sensitivity of pathogens leading sepsis in neonatal intensive care units (NICU) change over years. It is important to identify type and antibiotic sensitivity of pathogens leading sepsis for establishment of the local antibiotic policy. MATERIALS and METHODS: 87 cases with sepsis were investigated among 900 newborns followed in “Adnan Menderes University” NICU between January 2004-June 2008. Clinical symptoms and signs, risk factors, laboratory results, positive cultures and antibiotic sensitivity factors were evaluated in 45 cases with positive culture. RESULTS: Sepsis was found to have a 9.6% rate. 45 cases were diagnosed as definite sepsis with 49 positive blood cultures. 53% were males and 82% were premature. Most common pathogens were coagulase-negative staphylococci (CNS) and Staphylococcus aureus (S. aureus) in early neonatal sepsis, whereas CNS and the Candida in late neonatal sepsis. Mortality rate was 13.3%. Glycopeptide sensitivity of CNS was 100% , penicilline and meticilline resistance were 96% and 90% respectively. All S. aureus strains were sensitive to methicillin, clindamycine and eritromycine while penicillin resistance rate was 71.4%. No resistance was detected in Enterococcus spp. strains. Enterobacter spp. were 100% sensitive to 3. generation cephalosporins and carbapenems but resistant to ampicillin-sulbactam. Acinetobacter spp and Pseudomonas spp were resistant to piperaciline. All Klebsiella spp were sensitive to carbapenems, and aminoglycosides. No resistance was detected for the Serratia spp, Escherichia coli ve Enterococcus spp strains. CONCLUSION: Gram positive microorganisms as the leading etiologic agent in early neonatal sepsis, and their high penicillin resistance necessitated a revision in our ampiric antibiotic practices. However, no meticilline resistance was found in S. aureus species. High piperacilline resistance of Acinetobacter spp and Pseudomonas spp was associated with the recent frequent utilization of this agent.

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