Factors which affect mortality in neonatal sepsis.

AIM

Neonatal sepsis is an important cause of mortality and morbidity in newborns. The causative agents may be different in different units and may change in time. It was aimed to examine the microbiological agents leading to sepsis, clinical features and antibiotic resistances in babies with sepsis hospitalized in our unit in a two-year period.

MATERIAL AND METHODS

The clinical features, microbiological and laboratory results, antibiotic resistance patterns and mortality rates of the newborns with sepsis followed up in our unit between 2010 and 2011 were examined in the patient record system.

RESULTS

351 babies diagnosed with sepsis among 3219 patients hospitalized in the neonatal intensive care unit were included in the study. The mean gestational age was found to be 30.1±4.1 weeks, the mean birth weight was found to be 1417.4±759.1 g and the mean hospitalization time was found to be 43.6±34.4 days. Blood cultures were found to be positive in 167 (47.6%) patients, urine cultures were found to be positive in 6 (7.1%) patients and cerebrospinal fluid cultures were found to be positive in 34 (9.6%) cases. Candida grew in 5 patients (2 patients with early-onset sepsis and 3 patients with late-onset sepsis). The most common cause of sepsis was found to be staphylococci (coagulase negative staphylococcus was found in 65 patients (51%) and Staphylococcus aureus was found in 38 patients (39%). 49.6% (n=63) of the gram positive bacteriae and 60% (n=21) of the gram negative bacteriae were resistant to antibiotics. Six (7.1%) of the patients who were infected with these bacteriae were lost. In total 24 babies were lost because of sepsis. The bacteriae which caused to mortality with the highest rate included E. coli, coagulase negative staphylocicci, S. aureus and Klebsiella. Low birth weight, mechanical ventilation and parenteral nutrition were found to be significant risk factors in terms of mortality.

CONCLUSIONS

Staphylococci were found to be the most common agents in neonatal sepsis. Low birth weight, mechanical ventilation and parenteral nutrition are significant risk factors in terms of mortality.