Bacteriological Profile and Antibiotic Susceptibility Pattern of Neonatal Septicemia and Associated Factors of ICU Hospitalization Days

Abstract

Purpose To evaluate the microorganisms involved in neonatal septicemia and its antibiotic susceptibility pattern and to further investigate the factors associated with the length of intensive care unit (ICU) stay in neonatal septicemia. Patients and Methods A total of 297 infants with septicemia at neonatal ICU (NICU), Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology from 2016 to 2020 were enrolled. Identification of bacterial species was done using the standard positive blood culture. Data included demographics, signs at time of septicemia, laboratory values, patient sources, complications, microbiologic characteristics, and the duration of ICU stay. Univariate and multivariate gamma regression analyses were applied to determine the variables associated with ICU stay. Results The result demonstrated that the main causative pathogens of neonatal septicemia in our hospital were Gram-positive bacteria, among which Staphylococcus epidermidis (100 isolates, 47.17%) was the main conditional pathogens; Escherichia coli (27 isolates, 49.09%) was most frequently isolated among Gram-negative pathogens. Gram-positive bacteria had higher susceptibility to vancomycin, tigecycline and linezolid. Escherichia coli was susceptive to piperacillin (27/27, 100.00%), cefotetan (27/27, 100.00%), meropenem and imipenem (27/27, 100.00%). Streptococcus agalactiae (95% CI: 0.140–0.539), for patients who were transferred from other hospital (95% CI: 0.016 to 0.354), septicemia during hospitalization (95% CI: 0.411 to 0.825), the use of antibacterial drug during pregnancy (95% CI: 0.362 to 2.136), feeding intolerance (95% CI: 0.127 to 0.437), bradycardia (95% CI: 0.196 to 0.838), septicemia newborns have complications (95% CI: 0.063 to 0.291), the onset age (95% CI: 0.006 to 0.023), TRIPS score (95% CI: 0.005 to 0.016), and CRP level (95% CI: 0.002 to 0.005) were related to prolonged ICU stay days. Conclusion This study summarized common pathogens and associated drug sensitivity, and factors influencing ICU stay length. Prevention and control policy in the NICU should be strengthened.

Microbial Pattern of Neonatal Sepsis in the Neonatal Intensive Care Unit of dr. Ramelan Navy Central Hospital

“…This is in accordance with studies conducted by Pooja et al, Kurma et al, Govindaraju et al, and Kamalakannan, which stated that gram-negative rods are the main cause of neonatal sepsis [17], especially Klebsiella pneumoniae [18][19][20]. Contrary to this, Li et al found gram-positive rods as the main cause of neonatal sepsis in their study [21]. The probable reason is that newborns most probably acquire these gram-negative organisms from the maternal genital tract.…”

Prevalence and antibiotic susceptibility pattern of bacteria from sepsis suspected neonates at St. Paul Hospital Millennium Medical college, Addis Ababa, Ethiopia.

“…Our report showed that gram-negative bacteria were the predominant isolated organisms (79.8%) causing neonatal sepsis which was congruent with studies reported from Ethiopia 30% (33) Nigeria78.9% (30), Madagascar 81% (53) and Nepal 69.6% (54). On the contrary, studies in Ethiopia and other countries reported that gram positive bacteria were common cause of neonatal sepsis (23,49), Ghana (31), China (55) and Iran (56).…”

Bacterial Etiology and Antibiotic Susceptibility Profile in Neonatal Sepsis

“…In the present study, gram-positive organisms were most susceptible to vancomycin, imipenem, meropenem, and linezolid, and gram-negative microorganisms were mainly resistant to aminoglycosides and cefotaxime. In Li et al's study, gram-positive bacteria were more sensitive to vancomycin, tigecycline, and linezolid, and E. coli was 100% susceptible to piperacillin, cefotetan, meropenem, and imipenem (20). In the study of Stoll et al, most of the isolated microorganisms showed high sensitivity to ampicillin and gentamicin (16).…”

“…However, in the study by Li et (47.17%) was the primary conditional pathogen. Also, E. coli (49.09%) was mainly isolated among gram-negative pathogens (20). Furthermore, Peterside et al reported that gram-positive organisms (53.6%) were more frequent than gram-negative organisms (46.4%).…”