Microbiological profile of neonatal sepsis at a maternity hospital in Omdurman, Sudan

Abstract

Background: Neonatal sepsis is a clinical syndrome characterized by systemic signs of infection and accompanied by bacteremia in the first month of life. It is a major cause of morbidity and mortality in neonatal period. The study was conducted to determine microbiological profile and antibiogram of neonatal sepsis at Omdurman Maternity Hospital.

Methods: This was a cross-sectional hospital-based study involving 202 neonatal blood cultures at Omdurman Maternity Hospital during the period from April 2017 to April 2018. Specimens were cultured in Brain Heart Infusion broth followed by subculture of isolates on blood agar, MacConkey agar, and Chocolate agar and incubated aerobically at 37ºC for 24 h. The isolates were tested for their susceptibility to antimicrobial agents using the Kirby Bauer disc diffusion method.

Results: Of 202 positive blood cultures, 130 cases (64.4%) were early onset and 72 cases (35.6%) were recorded for late onset sepsis. Gram-negative pathogens approaching (123, 60.9%). Staphylococcus aureus was the most common organism in both groups of neonatal sepsis being isolated from (71, 35.7%), followed by Klebsiella pneumoniae (43, 21.2%). Gram-negative organisms were sensitive to Imepenem (97.3%) and Meropenem (80.5%) and resistant to third-generation Cephalosporins (65.3%) and Amoxicillin/Clavulanic acid (91.4%). Gram-positive organisms were resistant to Cefotaxime (75%), Amoxicillin/ Clavulanic acid (65.4%), and Clindamycin (68.2%); 91.6% of gram-positive isolates were sensitive to Vancomycin.

Conclusion: Gram-negative pathogens took the major spectrum of isolates. Klebsiella pneumoniae (21.2%) was the most frequent gram-negative organism. Methicillin resistant Staphylococcus aureus (MRSA) (33.7%) was the most common isolate. Most of the isolates were multidrug resistant. The best choice for treatment is Vancomycin (8.4%) and Imepenem (2.7%) for gram-positive and gram-negative, respectively. Adherence to antibiotic policy, antimicrobial surveillance, and policy updating is necessary.