Detection of Aerobic Bacteria Causing Neonatal Sepsis in Khartoum State Neonates

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.