Özkavaklı Ayberk, İmamoğlu Ebru Yalın, Önder Neslihan, İmamoğlu Serhat, Ovalı Hüsnü Fahri
Department of Pediatrics, Medeniyet University Faculty of Medicine, İstanbul, Türkiye.
Division of Neonatology, Department of Pediatrics, Medeniyet University Faculty of Medicine, İstanbul, Türkiye.
Turk Arch Pediatr. 2024 Jun 17;59(4):375-382. doi: 10.5152/TurkArchPediatr.2024.24006.
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.
本研究的目的是评估在新生儿重症监护病房中培养阳性的医院获得性迟发性新生儿败血症病例中分离出的微生物的抗生素耐药性。对2015年10月至2022年6月期间入住我们新生儿重症监护病房的婴儿进行了回顾性筛查。共分析了250名婴儿386起败血症事件中的458份不同培养物。在8年期间，共对4244名婴儿中的407例培养阳性的医院获得性迟发性新生儿败血症病例进行了回顾。21例因数据不足而被排除。培养阳性的医院获得性败血症的发生率为6.3%。凝固酶阴性葡萄球菌和金黄色葡萄球菌是培养物中最常见的革兰氏阳性菌。对氨苄西林和头孢菌素治疗的耐药性较高，而对万古霉素、替考拉宁和利奈唑胺的耐药性较低。克雷伯菌属是培养物中分离出的最常见革兰氏阴性菌，对非碳青霉烯类方案表现出高耐药性。培养物中分离出的唯一真菌微生物是念珠菌属，尽管其耐药性较低，但死亡率较高。医院获得性败血症的死亡率为19.6%。我们的研究表明，新生儿重症监护病房中的微生物及其抗生素耐药性谱随时间发生了变化。革兰氏阴性病原体表现出高抗生素耐药性，而真菌的死亡率较高。基于全面监测调整医院获得性败血症的经验性抗生素方案至关重要。
