To conduct a survey of the local prevalent bacteria and antibiotic resistance in a referral tertiary neonatal intensive care unit (NICU), in order to assess the efficacy of local antibiotic policies. We reviewed all positive blood and cerebrospinal fluid cultures obtained between January 2007 and December 2017 in the NICU of Schneider Children’s Medical Center of Israel. Early and late-onset bacteremia were defined as episodes occurring within or after the first 3 calendar days of life respectively. Empiric treatment included ampicillin and gentamicin or piperacillin-tazobactam and amikacin for early or late-onset bacteremia respectively. The prevalence and antibiotic resistance of the bacteria were described and compared over time. Eight hundred and twenty nine of 15,947 (5.2%) newborns had at least one episode of bacteremia; 81 had multiple episodes. The most common bacteria were Escherichia coli (32.35%) and group B Streptococcus (19.11%) or coagulase negative Staphylococcus (CoNS) (60.5%) and Klebsiella sp. (12.4%) in early or late-onset bacteremia respectively. Overall, all Gram-positive bacteria were susceptible to vancomycin and most non-CoNS to ampicillin. Nosocomial vs. vertical bacteremia had increased resistance to ampicillin and cephalosporins. Resistance of nosocomial bacteria to piperacillin-tazobactam was 22.4%, to amikacin 3.3%, and to meropenem 1.8%. Changes over time: Gram-negative bacteria had a significant increase in resistance to cotrimoxazole and piperacillin. The resistance to gentamicin doubled. Our empiric antibiotic regimen covers the most frequent isolates. Amikacin may replace gentamicin for selected sick patients in early-onset bacteremia. Piperacillin-tazobactam should be combined with amikacin until susceptibility is available.

在转诊三级新生儿重症监护病房（NICU）中对当地流行细菌和抗生素耐药性进行调查，以评估当地抗生素政策的有效性。我们回顾了2007年1月至2017年12月在以色列施耐德儿童医学中心的重症监护病房（NICU）中获得的所有阳性血液和脑脊液培养物。早期和晚期发病菌血症分别定义为在生命的前3个日历日之内或之后发生的发作。经验性治疗分别包括氨苄西林和庆大霉素或哌拉西林-他唑巴坦和阿米卡星用于早发或晚发菌血症。描述并比较了细菌的患病率和抗生素耐药性。15,947名新生儿中有129名（5.2％）新生儿至少有一次菌血症。81有多个情节。最常见的细菌是大肠杆菌（32.35％）和B组链球菌（19.11％）或凝固酶阴性葡萄球菌（CoNS）（60.5％）和克雷伯菌sp。（12.4％）分别为早发或晚发菌血症。总体而言，所有革兰氏阳性细菌均对万古霉素敏感，而大多数非CoNS对氨苄西林敏感。医院感染与垂直菌血症对氨苄西林和头孢菌素的耐药性增加。医院细菌对哌拉西林-他唑巴坦的耐药率为22.4％，对丁胺卡那霉素的耐药率为3.3％，对美罗培南的耐药率为1.8％。随时间的变化：革兰氏阴性细菌对cotrimoxazole和piperacillin的抵抗力显着增加。对庆大霉素的抵抗力增加了一倍。我们的经验性抗生素治疗方案涵盖了最常见的分离株。阿米卡星可以替代庆大霉素，用于某些早发菌血症的特定患者。哌拉西林-他唑巴坦应与丁胺卡那霉素合用，直到易感为止。