Bacterial aetiological agents of neonatal sepsis, risks associated with acquisition, and the susceptibility of these organisms to commonly used antimicrobial agents

Abstract

Background: Neonatal sepsis is estimated to cause 26% of all neonatal deaths worldwide. The incidence is higher in developing  countries, responsible for about 30-50% of neonatal deaths.

Objective: This study aimed to determine the bacterial aetiological agents of neonatal sepsis, risks associated with acquisition, and the  susceptibility of these organisms to commonly used antimicrobial agents.

Design, Setting and study participants: This was a retrospective cross-sectional study involving a review of inpatient and laboratory  records of neonates admitted to Kenyatta National Hospital in period of January 2013 to December 2013.

Outcome measures: Bacterial agents from positive blood cultures and their antibiotic susceptibility pattern.

Results: A total of 226 positive blood culture reports were randomly selected for this study, with 116 (51.3%) isolates from female patients  and 110 (48. 7%) from male patients. Coagulase-negative staphylococcus was the most commonly isolated organism (30.1%),  followed by Enterobacter spp (19.9%), Citrobacter spp (12.8%), Klebsiella spp (11%) spp, with 26.2% divided among others. There was high  resistance to antibiotics such as ceftriaxone (75.2%), cefuroxime (72.6%), ampicillin (82.9%), ceftazidime (67.1%) and gentamicin  (65.6%). There was high sensitivity to vancomycin (100%), amikacin, piperacillin-tazobactamobactam (89.7%), teicoplanin (93.5%),  imipenem (93.3%), meropenem (90.8%), piperacillin-tazobactamobactam (89.7%), amikacin (87.0%) and levofloxacin (83.8%).  

Conclusions: Gram-negative organisms and Coagulase Negative Staphylococci were the leading cause of neonatal sepsis, most of which  were resistant to multiple antibiotics. Continuous surveillance for antibiotic susceptibility should be done to look for resistance patterns.