Antimicrobial Resistance among neonates with neonatal Sepsis in Morogoro, Tanzania

Abstract

Background: Neonatal sepsis increases neonatal morbidity and mortality in low- and middle-income countries. However, the prevalence of neonatal sepsis, etiological agents, and antimicrobial resistance patterns have not been documented in areas with the highest neonatal mortality rates in Tanzania.

Aim: This study aimed to investigate the prevalence of neonatal sepsis, identify the primary causative agents, and understand their resistance patterns at Morogoro Regional Hospital.

Methods: The study involved 252 admitted neonates at Morogoro Regional Hospital and was carried out between March and June 2019. Clinical and demographic information for each neonate was collected using a standardized questionnaire. Blood samples were obtained from all 252 neonates, and 50 swabs were randomly taken from neonates with umbilical pus discharge. The samples were cultured using aseptic techniques on blood, chocolate, and MacConkey agar. The identification of the causative agents relied on the characteristics of colony morphology, gram staining, and biochemical tests. Antimicrobial resistance patterns were determined using the disc diffusion method with Muller Hinton agar against Ampiclox, Erythromycin, Gentamycin, Nalidixic acid, Ciprofloxacin, Norfloxacin, Ofloxacin, Kanamycin, Co-trimoxazole, Cephalexin, Ceftriaxone, and Amikacin.

Results: The prevalence of neonatal sepsis, as determined through blood culture, was 40 % (102 /252). The predominant bacteria isolated from blood cultures were E. coli 31 %, Staphylococcus aureus 23 %, and Citrobacter spp 16%. Around 50% of the gram-negative bacteria resisted Ceftriaxone, a third-generation cephalosporin. Both gram-negative bacteria and Staphylococcus aureus displayed resistance to Ampiclox.

Conclusion: E. coli, Staphylococcus aureus, and Citrobacter spp. were shown to be the most frequent bacteria in neonatal sepsis in Morogoro. Many isolates were Ampicillin-resistant. Neonatal sepsis is common in Morogoro, highlighting the need for innovative neonatal care and preventative techniques.