35 Original article Folia Med. Fac. Med. Univ. Saraeviensis 2017; 52(1): 35-39 foliamedica.mf.unsa.ba Etiological agents of infections in neonatal intensive care units Mufida Aljičević 1 * , Faris Kadić 2 , Velma Rebić 1 , Sabina Mahmutović Vranić 1 , Aida Kadić 3 1 Department of Microbiology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina 2 Zavod za javno zdravstvo Una-Sana Canton, Bihac, Bosnia and Herzegovina 3 Neonatology Department of the Cantonal Hospital „Dr. Irfan Ljubijankic“ Bihac, Bosnia and Herzegovina Submitted: 5.3.2017. / Accepted: 27.5.2017. *Corresponding author Mufida Aljičević Faculty of Medicine, University of Sarajevo, Čekaluša 90, 71000 Sarajevo, Bosnia and Herzegovina email: mufida.aljicevic@mf.unsa.ba ABstract Objectives: Neonatal or newborn period includes the frst 28 days after the birth of a child. Te immune sistem of a newborn is not fully developed and can not be completely efective op- pose to pathogens which the infant can be exposed perinatally or in the period just before birth and seven days after. Te aim of this study was to identify the most common causative agents of neonatal infections and the movement of infections through the observed period. Material and methods: Tis retrospective analytical study re- cruited 160 patients admitted to the Neonatology Department of the Cantonal Hospital „Dr Irfan Ljubijankic“ in Bihać, in the period from January 2013 to December 2014 on suspicion of neonatal infection. Results: Of 160 neonates suspected on neonatal infections in 123 (76,9%) was confrmed. Most neonates were admitted in the period from October to December 2013 (n=31, 19,4%). Most neonates with confrmed neonatal infection were ad- mitted in the period from January to March 2013 (n=25, 20.3%). Te most common diagnosis was Infectio perinatalis (n=57, 28,5%). Of the 87 isolated pathogens 65% (n=57) were Gram-positive, from which the most common were Staphylo- coccus aureus and MRSA 82,5% (n=47). Conclusion: Of the total number of neonates admitted on sus- picion of neonatal infection, healing was result in 75% (n=120), neurological defcit in 18,1% (n=29), and the death in 6,9% (n=11) neonates. Keywords: neonates, Infectio perinatalis, Staphylococcus au- reus, neurological defcit © 2017 Folia Medica Facultatis Medicinae Universitatis Saraeviensis. All rights reserved. Introduction Neonatal or newborn period includes the frst 28 days after the birth of a child, so-called postnatal life. Al- though the development of specifc immune system begins early in the intrauterine period, the immune system of the newborn is not fully developed and can not oppose pathogens which can be directly exposed before birth to seven days after. A newborn is in the frst days of extrauterine life protected with IgG antibodies which are maternal origin. Tey are transplacentarily transferred mostly in the last trimester of pregnancy. Antibodies IgM and IgA do not cross the placenta, but a large amount of secretory IgA antibodies newborn is received by colostrum [1]. Neonatal infections are in- fections that happened during the frst 28 days of life. Te fetus is protected against bacterial infection, but after birth it comes to the colonization and the estab- lishment of normal microfora. Some bacteria can lead to infection of the placenta and fetus infection in ute- ro or to the development of neonatal infection during childbirth. Serious /acute/ neonatal infections include sepsis, meningitis, pneumonia and urinary tract infec- tion. Tere are also possible focal bacterial infections (skin, navel and conjunctiva) and fungal, viral and pro- tozoal infections /candidiasis, TORCH/ [2, 3]. Neona- tal sepsis goes below a picture of bacteremia and sys- temic infection, and despite good antimicrobial thera- py remains a major cause of morbidity and high infant mortality. Te most common bacterial pathogens are β hemolytic Streptococcus group B (Streptococcus aga- lactiae), coagulase-negative Staphylococcus (CONS), Staphylococcus aureus, Escherichia coli, Haemophilus infuenzae, Listeria monocytogenes, Klebsiella, Pseu- domonas, Enterobacter, Serratia, Acinetobacter and anaerobic bacteria [4]. Newborn, and particularly those born prematurely, has sepsis often with has purulent meningitis. Clinical symptoms are non-specifc and are characterized by an unstable temperature, drowsi- ness, abnormal or so called cerebral cry, apnea, seizures,