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Korean Journal of Pediatrics 2006;49(6):623-629.
Published online June 15, 2006.
Analysis of causative microorganisms and choice of antibiotics according to the onset of neonatal sepsis
June Seung Sung, Dong Yeon Kim, Sun Hee Kim, Hyung Suk Byun, Tai Ju Hwang, Young Youn Choi
Department of Pediatrics, Chonnam University Medical School
신생아 패혈증에서 발현시기에 따른 원인균 분석과 항생제 선택
성준승, 김동연, 김선희, 변형석, 황태주, 최영륜
전남대학교 의과대학 소아과학교실
Correspondence:  Young Youn Choi,
Email: yychoi@chonnam.ac.kr
Abstract
Purpose
: The mortality rate of neonatal sepsis has been decreased, however, the incidence has not significantly decreased because of increased invasive procedures. This study was designed to make guidelines for choosing antibiotics by analyzing the causative microorganisms and their antibiotics sensitivity test according to the onset of neonatal sepsis.
Methods
: One hundred seven cases of culture proven sepsis in 89 patients admitted to the NICU of Chonnam University Hospital from Jan. 2000 to Dec. 2004, were enrolled. By reviewing the medical records, clinical data, laboratory findings, causative organisms and their antibiotics sensitivity, and mortality were analyzed.
Results
: The incidence of neonatal sepsis was 1.7 percent and more prevalent in premature and low birth weight infants. 85.4 percent of neonatal sepsis was late onset. Almost all microorganisms(92.9 percent) were gram-positive in early onset, however, two thirds were gram-positive and one third were gram-negative and Candida in late onset. Gram-negative organisms and Candida were more prevalent in patients who had central line. Gram-positive organisms were sensitive to vancomycin, teicoplanin, and gram-negative were sensitive to imipenem, and cefotaxime.
Conclusion
: Neonatal sepsis was more prevalent in premature and low birth weight infants. More than 90 percent were gram-positive in early onset, however, one third was gram-negative and Candida in late onset. The first choice of antibiotics were a combination of third generation cephalosporin and clindamycin in early onset, and third generation cephalosporin and glycopeptide in late onset. If there is no response to antibiotics treatment, the use of antifungal agents should be considered.
Key Words: Neonatal sepsis , Early , Late , Antibiotics


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