A ten-year review of neonatal bloodstream infections in a tertiary private hospital in Kenya

Abstract

Introduction: Neonatal mortality in developing countries is usually due to an infectious cause. The gold standard of investigation in developing countries is a positive blood culture. It is important to know the aetiology of neonatal bloodstream infections so that empiric treatment can be effective. Methodology: We conducted a retrospective clinical audit over ten years between January 2000 until December 2009, looking at the aetiology of both early and late onset neonatal sepsis. We analysed data from 152 (23%) patient isolates out of 662 suspected cases of neonatal sepsis. Results: Our study revealed that Gram-positive organisms were the predominant cause of both early and late onset sepsis; the common isolates were Staphylococcus epidermidis (34%) and Staphylococcus aureus (27%). There were no isolates of group B Streptococcus. Candida species was isolated only in patients with late onset sepsis (6.9%). Bacterial isolates were relatively sensitive to the commonly used first-and second-line empiric antibiotics. Conclusion: Gram-positive organisms remain the major cause of neonatal bloodstream infections in our setup. The findings of this study will guide clinicians in prescribing the right empiric therapy in cases of suspected neonatal sepsis before the definitive culture results are obtained.

Neonatal Septicemia: Isolation, Identification and Antibiotic Sensitivity Pattern of Bacteria in a Tertiary Hospital in Bangladesh

“…A lower isolation rate was also reported by Hiral et al 23 in Gujrat, India where they found 9.92% E.coli. Isolation rate of Klebsiella pneumoniae in the present study was 6.06%, which was comparable to some other studies 7,17,19,24 . A higher isolation rates was also observed in other studies 6,19,25 .…”

“…A higher isolation rates was also observed in other studies 6,19,25 . Pseudomonas aeruginosa was isolated at the rate of 3.03% which was comparable to other studies 6,[24][25][26] . A higher isolation rates was also observed by others 7,22 .…”

Epidemiology of Neonatal Sepsis and Implicated Pathogens: A Study from Egypt

“…Other Gram-negative bacilli were recovered but in a few numbers. The predominance of Klebsiella among the causative Gram-negative pathogens was also reported in other studies in Egypt [45, 48] and other different countries [24, 25, 39, 40, 46, 51]. On the contrary, other Gram-negative bacteria such as E. coli [35, 47, 52], P. aeruginosa [34, 53], and Enterobacter spp.…”

An overview of Staphylococcus epidermidis and Staphylococcus aureus with a focus on developing countries

“…In three different hospitals Iran, nasal swabs were collected from 163 healthcare workers; 96 were cultured and resulted positive for S. epidermidis [14]. Similar results were reported in a study performed between 2000 and 2009 in a hospital in Kenya, where in blood samples collected from neonates, S. epidermidis accounted for 33% of the isolated strains [15]. Furthermore, a study carried out in Brazil showed that 2.7% of S. epidermidis strains were isolated from hospital healthcare wastes, indicating a potential risk of spread outside the hospital setting [16].…”