Abstract:
Neonatal sepsis is one of the most common reasons for
admission to neonatal units in developing countries. It is also a
major cause of mortality in both developed and developing
countries. The type and pattern organisms that cause neonatal
sepsis changes over time and vary from one hospital to another
hospital, even in the same country. In addition the causative
organisms have developed increased drug resistance for the
last two decades. Maternal, neonatal and environmental risk
factors have contributed for the development of sepsis.
This study was undertaken to determine the pattern of aerobic
bacterial agents causing neonatal sepsis and to assess their
susceptibility pattern to various antimicrobial agents. An
attempt has been also made to identify the possible maternal
and neonatal risk factors responsible for neonatal septicemia.
During the period of April to October 2013 a cross-sectional
prospective study was conducted at El Swedey Pediatrics
Charity
Hospital,
Khartoum,
Sudan.
Blood
cultures
were
performed from newborn babies (n=100) admitted to the
hospital
with
a
clinical
diagnosis
of
neonatal
sepsis.
Antimicrobial susceptibility testing was performed for all blood
culture isolates according to the criteria of the National
Committee for Clinical Laboratory Standards by disk diffusion
method.
Of the 100 patients, 55% were males and 45% were females. A
total of 22 (22%) neonates presented with early-onset sepsis
(EOS) and 78 (78%) presented with late-onset sepsis (LOS). Of
the 100 neonates investigated for sepsis, 18 (18%) were
positive for blood culture. The Gram-positive and negative
bacteria accounted for 33.3% and 66.7% respectively (p>
0.05). The most common isolated organisms were Klebsiella
spp. (27.8%) and
P. aeruginosa (22.2%). Neonatal
risk factors such as prematurity and low birth weight. No
maternal risk factors were identified.
Klebsiella spp. and P. aeruginosa were the most common
organisms causing neonatal sepsis. Prematurity and low birth
weight showed insignificant association with blood culture
proven to be neonatal sepsis. Gram-negative bacteria showed
high level of resistance to commonly used antibiotics.
In general both Gram positive and negative bacteria isolated
from blood culture showed low resistance rates to amikacin,
meropenem and gentamicin.
Amikacin was the most effective drug when compared to other
drugs tested against the Gram-positive and Gram-negative
bacteria.
The knowledge of these patterns is essential when local polices
on the uses of antibiotics are being devised.
