Investigation of the Agents Isolated From the Blood Cultures of a University Hospital Neonatal Intensive Care Unit and Their Antimicrobial Susceptibility [2]

Introduction: Neonatal sepsis is a clinical syndrome characterized by non-specific signs and symptoms caused by various pathogens. The diagnosis is based on a combination of clinical and laboratory findings. Gram-positive and Gram-negative bacteria are the predominant etiologic agents. In our study,we aimed to evaluate the types of microorganisms grown in neonatal blood cultures and antimicrobial susceptibilities of Gram-negative agents. Materials and Methods: We retrospectively analyzed 2566 blood culture results. Samples from blood culture bottles with growth were passaged on blood agar. The growing colonies were identified by MALDİ-TOF MS. Antibiotic susceptibility tests were performed on a fully automated device. The results were evaluated according to EUCAST standards. Results: Growth was detected in 12.1% of the samples. 59.5% of the patients with growth were male. 66% of the patients were at term and 53.7% had early-onset sepsis. 74.6% of the cases were cesarean section and 59.5% were above 2500 grams. Coagulase-negative staphylococci (CNS) were the most common organisms grown in early and late-onset sepsis. 73.9% CNS, 9% Gram-negative enteric and nonfermentary bacilli, 2.9% Gram-positive bacilli and 0.1% fungi were grown. 40% of S.aureus were methicillin resistant. The most antimicrobial-resistant Gram-negative agent was Klebsiella spp. Klebsiella spp. isolates were resistant to amikacin 9%, ampicillin 100%, cefepime 72.7%, ceftazidime 81.8%, gentamicin 81.8%, meropenem 9.1%. Extended spectrum beta lactamase was positive in 90.9%. Acinetobacter spp. isolates were resistant to amikacin 42.8%, ampicillin 42.8%, gentamicin 42.8%, meropenem 42.8%. Conclusion: Microorganism species and antibiotic susceptibilities in intensive care units vary over time and between clinics. Broad-spectrum antimicrobials started early with suspicion of sepsis without culture confirmation can be replaced with agent-specific narrow-spectrum antimicrobials when growth is detected in culture,monotherapy can be switched or treatment can be terminated early. This may contribute to the prevention of resistance development. © Telif Hakkı 2023 Bursa Uludağ Üniversitesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı / Güncel Pediatri, Galenos Yayınevi tarafından yayınlanmıştır.