Neonatal sepsis in hospital-born babies: bacterial isolates and antibiotic susceptibility patterns

Abstract

Objective: To determine the frequency of bacterial isolates from neonatal blood cultures and their susceptibility patterns in hospital-born babies having sepsis.

Design: An observational study.

Place and duration of study: Obstetrics Unit and Special Care Baby Unit of Khyber Teaching Hospital, Peshawar from 1st January to 31st December 2001.

Subjects and methods: This study was carried out on the neonates born and admitted in hospital with positive blood culture reports. Early onset neonatal sepsis (EONNS) and late onset neonatal sepsis (LONNS) were defined as illness appearing from birth to seven days and from eight to twenty-eight days postnatal age respectively. The blood culture reports were analyzed by SPSS package and cross tabulation was done.

Results: One hundred and twelve hospital-born babies presented with sepsis. Sixty-seven neonates had positive cultures. Escherichia coli (E. coli) was the commonest organism causing EONNS (35; 77.1%) followed by Pseudomonas (4; 8.9%), Klebsiella (4; 8.9%) and Staphylococcus aureus (2; 4.4%) respectively. In the LONNS E. coli (19; 77.3%) was the commonest followed by Staphylococcus and Pseudomonas (2; 9% each) and Klebsiella (1; 4.5%). The gram-negative organisms showed high degree of resistance to commonly used antibiotics, ampicillin (79.3%), amoxicillin (74.6%) and ceftazidime (71.6%), cefotaxime (55.2%) and comparatively low resistance to gentamicin (43.2%), tobramycin (34.3%), imipinem (23.6%), amikacin (22.3%), ofloxacin and ciprofloxacin (11.9%) respectively. Staphylococcus aureus showed almost the same resistance to ampicillin, 75%, and comparatively low resistance to the rest of the antibiotics as compared to the gram-negative organisms.

Conclusion: Neonatal sepsis is mainly caused by gram-negative organisms, which are developing resistance to commonly used antibiotics.