Causative organisms, antibiotic sensitivity patterns and risk factors associated with neonatal sepsis at Moi Teaching and Referral Hospital, Kenya

Abstract

Background: Neonatal bacterial infections have been associated with rising antimicrobial resistance levels. This has led to increasing neonatal morbidity and mortality in poorly resourced health facilities located in low-income countries. Local studies on neonatal antibiotic sensitivity patterns and its associated risk factors could inform empirical antibiotic therapy and hospital infection control
strategies.

Purpose: This study aimed at determining the causative organisms, antibiotic sensitivity patterns and risk factors associated with neonatal sepsis at a tertiary teaching hospital in Western Kenya.

Materials and Methods: Cross-sectional study among neonates suspected to have sepsis and undergoing treatment at Moi Teaching and Referral Hospital (MTRH’s) newborn unit (NBU) between September 2017 and July 2018. Blood culture tests isolated bacteria and determined their antimicrobial sensitivity. Neonatal and maternal characteristics were obtained through medical chart reviews. Descriptive statistics, Pearson chi-square test of association and odds ratios were adopted.

Results: The study enrolled 141 neonates, majority (57.4%) of whom were female. The median gestational age and birth weight were 37 (IQR: 22-45) weeks and 2400g (IQR: 800 - 4700) respectively. Of the 151 bacterial isolates identified, 46.4% were Klebsiella spp. followed by coagulase-negative Staphylococci (CoNS) at 27.8%. Klebsiella spp. was sensitive to meropenem, amikacin and cefepime but
resistant to ceftriaxone, gentamicin and cefotaxime. However, CoNS was sensitive to vancomycin and penicillin. Both the neonatal and maternal risk factors assessed were not associated with neonatal sepsis.

Conclusion: The main bacterial causes of neonatal sepsis were Klebsiella spp. and CoNS which were both sensitive to meropenem and amikacin.