Bacteriological profile and antibiotic resistance in newborn infants with possible community-acquired neonatal sepsis in Khartoum State, Sudan

Abstract

Neonatal sepsis is a leading cause of morbidity and mortality, and knowledge of bacterial patterns and susceptibility to antibiotics is essential to design therapeutic guidelines. To determine the bacterial aetiology and antibiotic resistance patterns in neonatal sepsis, a prospective, cross-sectional, hospital-based study was conducted in a large paediatric emergency hospital in Khartoum State, Sudan, over a 6-month period. All newborn infants with a clinical diagnosis of sepsis were included in the study and had a blood sample collected for culture and sensitivity. The World Health Organization case definition of neonatal sepsis in conjunction with the Integrated Management of Childhood Illnesses criteria was used to select patients. A total of 170 newborn infants fulfilled the study inclusion criteria. The median age at presentation was 4-7 days and blood culture was positive in 31%. Early-onset neonatal sepsis was present in 30% of cases, while 70% were late-onset. Gram-positive organisms accounted for 58% of the total isolates, and 38% were Gram-negative organisms. Staphylococcus aureus was the most prevalent organism (55% of all isolates) and 72% of these were methicillin-resistant which showed 100% sensitivity to vancomycin and 90% to gentamycin. Pseudomonas aeruginosa was the commonest Gram-negative organism in both early and late-onset sepsis and the second commonest isolated organism, accounting for 19% of cases. All Gram-negative organisms were 100% sensitive to imipenem, meropenem and ciprofloxacin. Both Gram-positive and Gram-negative organisms were highly resistant to benzylpenicillin and cefotaxime, the commonly used empiric antibiotics in neonatal sepsis.

Keywords: Bacteria; Community-acquired; Neonatal sepsis; Sudan; Susceptibility to antibiotics.

Figure 1.

The frequency of isolated organisms causing possible community-acquired neonatal sepsis. E. coli, Escherichia coli; GBS, Group B Streptococcus.