Identification of bacterial agents and antimicrobial susceptibility of neonatal sepsis: A 54-month study in a tertiary hospital

Abstract

The spectrum of bacteria which cause neonatal sepsis varies in different parts of the world. Antibiotic resistance is an increasing problem of these bacteria. The aim of this study was to detect the most common bacterial causes of neonatal sepsis and determination of their sensitivity to antibiotics. In a descriptive cross-sectional study, records of the neonates suspicious to neonatal sepsis who were admitted to Neonatal Intensive Care Unit (NICU) were assessed. Neonates with positive blood culture along with clinical signs of sepsis were entered in the study. Evaluated data included: age, sex, birth weight, type of infection, type of isolated pathogen, antibiotic sensitivity and disease outcome. Of 3700 screened blood cultures, 153 (4.1%) reported as positive, 76.5% of the evaluated neonates were preterm, 142 (92.8%) had gram negative sepsis and 11 (7.2%) had gram positive sepsis. The most common isolated gram negative bacteria were Klebsiella pneumoniae (46.4%), enterobacter spp. (17.6%) and Escherishia coli (14.4%). Coagulase negative staphylococci (CONS) were the most prevalent gram positive bacteria (5.9%) in this study. All of the klebsiella and enterobacter strains were resistant to ampicillin and gentamicin. The sensitivity of K. pneumoniae and enterobacter to imipenem was: 90 and 92.5%, respectively. Prevalence of early and late-onset sepsis was 64.7 and 35.3% respectively. Mortality rate of sepsis in this study was reported as 53.5%. In conclusion, the most common cause of bacterial sepsis in this study was K. pneumoniae which was completely resistant to ampicillin and gentamicin. So empirical treatment of sepsis with ampicillin and gentamicin in Imam Khomeini NICU must be reconsidered.