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

Park,  Hye Won; Lim,  Gina; Koo,  So Eun; Lee,  Byong Sop; Kim,  Ki Soo; Pi,  Soo Young; Kim,  Ai Rhan

Original Article

Journal of the Korean Society of Neonatology 2009;16(2):172-181.
Published online November 1, 2009.

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

Hye Won Park, Gina Lim, So Eun Koo, Byong Sop Lee, Ki Soo Kim, Soo Young Pi, Ai Rhan Kim

Department of Pediatrics, Division of Neonatology, University of Ulsan College of Medicine, Childrens Hospital, Asan Medical Center, Seoul, Korea. arkim@amc.seoul.kr

단일 신생아중환자실에서 경험한 10년간의 신생아 패혈증의 원인균 및 항생제 감수성 변화

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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.

Key Words: Neonatal sepsis; Causative organism; Antibiotic susceptibility