{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T10:58:47Z","timestamp":1775473127889,"version":"3.50.1"},"reference-count":29,"publisher":"Medical Association of Zenica-Doboj","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicinski Glasnik"],"published-print":{"date-parts":[[2020,7,12]]},"abstract":"<jats:p>&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Aim &amp;lt;br \/&amp;gt;&amp;lt;\/strong&amp;gt;Steady progress in intensive treatment worldwide has increased the survival of immature neonates, but with multiple invasive procedures, which have increased the risk of infection, thus the bacterial resistance to antibiotics. The aim of this study was to analyse the epidemiology of multidrug resistance pathogens as causative agents of neonatal sepsis in the neonatal intensive care unit. &amp;lt;br \/&amp;gt;&amp;lt;strong&amp;gt;Methods&amp;lt;br \/&amp;gt;&amp;lt;\/strong&amp;gt;A retrospective cohort study conducted at the Intensive care unit of the Paediatric Clinic of Tuzla over a three-year period (2016-2018) analysed epidemiology of neonatal sepsis caused by multidrug resistance pathogens. Statistical analysis applied standard methods, and the research was approved by the Ethics Committee of the institution. &amp;lt;br \/&amp;gt;&amp;lt;strong&amp;gt;Results&amp;lt;br \/&amp;gt;&amp;lt;\/strong&amp;gt; Of the total of 921 treated neonates, multidrug resistance (MDR) pathogens among causative agents of neonatal sepsis were found in 22 neonates (2.38%) with no gender difference. Prematurity and low birth weight were confirmed as the most significant risk factors. From the maternal risk factors a significant difference was found in the first birth and in vitro fertilization. Clinically, MDR sepsis manifested frequently as late onset sepsis, with longer hospital stay and higher mortality. The findings of leukopenia, thrombocytopenia and coagulation disorders were significant. Gram negative bacteria were frequently isolated, in particular Acinetobacter, which showed the greatest resistance to antibiotics. &amp;lt;br \/&amp;gt;&amp;lt;strong&amp;gt;Conclusion&amp;lt;br \/&amp;gt;&amp;lt;\/strong&amp;gt; Neonatal MDR sepsis is a threat to life, it complicates the treatment, increases costs and mortality. Outcomes can be improved by preventive strategies, earlier and more accurate diagnosis and rational use of antibiotics.&amp;lt;\/p&amp;gt;<\/jats:p>","DOI":"10.17392\/1157-20","type":"journal-article","created":{"date-parts":[[2024,4,21]],"date-time":"2024-04-21T10:28:16Z","timestamp":1713695296000},"page":"375-382","source":"Crossref","is-referenced-by-count":2,"title":["Epidemiology of neonatal sepsis caused by multidrug resistant pathogens in a neonatal intensive care unit level 3"],"prefix":"10.17392","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4037-3736","authenticated-orcid":false,"given":"Devleta","family":"Had\u017ei\u0107","sequence":"first","affiliation":[{"name":"Paediatric Clinic, University Clinical Centre of Tuzla","place":["Tuzla,Bosnia and Herzegovina"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fahrija","family":"Skoki\u0107","sequence":"additional","affiliation":[{"name":"Paediatric Clinic, University Clinical Centre of Tuzla","place":["Tuzla,Bosnia and Herzegovina"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selmira","family":"Brki\u0107","sequence":"additional","affiliation":[{"name":"School of Medicine University of Tuzla","place":["Tuzla,Bosnia and Herzegovina"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amina","family":"Sara\u010devi\u0107","sequence":"additional","affiliation":[{"name":"Paediatric Clinic, University Clinical Centre of Tuzla","place":["Tuzla,Bosnia and Herzegovina"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delila","family":"Softi\u0107","sequence":"additional","affiliation":[{"name":"School of Medicine University of Tuzla","place":["Tuzla,Bosnia and Herzegovina"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D\u017eenana","family":"Softi\u0107","sequence":"additional","affiliation":[{"name":"Paediatric Clinic, University Clinical Centre of Tuzla","place":["Tuzla,Bosnia and Herzegovina"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"49509","published-online":{"date-parts":[[2020,7,12]]},"reference":[{"key":"ref1","first-page":"304","article-title":"Surviving sepsis campaign: international guidelines for management of sepsis and septic shock","author":"Rhodesa","year":"2016. 2017","unstructured":"RhodesA, Evans LE, Alhazzani W,Levy MM, Anto-\nnelli M, Ferrer R, Kumar A, Sevransky JE, Sprung \nCL, Nunnally ME, Rochwerg B, Rubenfeld GD, \nAngus DC, Annane D, Beale RJ, Bellinghan GJ, \nBernard GR, Chiche JD, Coopersmith C, De Backer \nDP, French CJ, Fujishima S, Gerlach H, Hidalgo JL, \nHollenberg SM, Jones AE, Karnad DR, Kleinpell \nRM, Koh Y, Lisboa TC, Machado FR, Marini JJ, \nMarshall JC, Mazuski JE, McIntyre LA, McLean \nAS, Mehta S, Moreno RP, Myburgh J, Navalesi P, \nNishida O, Osborn TM, Perner A, Plunkett CM, Ra-\nnieri M, Schorr CA, Seckel MA, Seymour CW, Shi-\neh L, Shukri KA, Simpson SQ, Singer M, Thompson \nBT, Townsend SR, Van der Poll T, Vincent JL, Wier-\nsinga WJ, Zimmerman JL, Dellinger RP. 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Federal Register 2014; 184:56931-5.","journal-title":"Federal Register"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/S0140-6736(15)00474-2","article-title":"Access to effective antimicrobials: a worldwide challenge","author":"RLaxminarayanR","year":"2016","unstructured":"Laxminarayan R, Matsoso P, Pant S, Brower C, \nRottingen JA, Klugman K, Davies S. Access to \neffective antimicrobials: a worldwide challenge. \nLancet 2016; 387:168-75.","journal-title":"Lancet"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"145","DOI":"10.3233\/NPM-1765","article-title":"Distribution, antimicrobial resistance and predictors of mortality in neonatal sepsis","author":"TBandyopadhyayT","year":"2018","unstructured":"Bandyopadhyay T, Kumar A, Saili A, Randhawa VS. \nDistribution, antimicrobial resistance and predictors \nof mortality in neonatal sepsis. 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Arch Dis Child Fetal Neonatal Ed \n2018; 103:474-8.","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"ref15","first-page":"38","article-title":"Distribution of late-onset neonatal sepsis pathogens differs in inpatient and outpatient settings","author":"CBlackC","year":"2018","unstructured":"Black CG, Tavares L, Stachel A, Ratner AJ, Randis \nTM. Distribution of late-onset neonatal sepsis patho-\ngens differs in inpatient and outpatient settings. Am \nJ Perinatol 2018; 105:38-43.","journal-title":"Am J Perinatol"},{"key":"ref16","first-page":"60","article-title":"Culture-proven neonatal sepsis in preterm infants in a neonatal intensive care unit over a 7 year period: coagulase-negative Staphylococcus as the predominant pathogen","author":"HOzkanH","year":"2014","unstructured":"Ozkan H, Cetinkaya M, Koksal N, Celebi S, Ha-\ncimustafaoglu M. 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