Neonatal Sepsis in a Resource-Limited Setting: Causative Microorganisms and Antimicrobial Susceptibility Profile

Abstract

Background. Empiric treatment of suspected neonatal sepsis must be based on data on setting-specific causative pathogens and their respective susceptibilities to antimicrobials, as well as universal treatment guidelines. This approach will ensure better therapeutic outcomes and reduce mortality. Objectives. The objectives of this study were to determine the bacteriological profile and antibiotic susceptibility pattern of isolated microorganisms responsible for neonatal sepsis in a regional hospital in Ghana. Methods. This was a retrospective study that assessed causative microorganisms and antimicrobial susceptibility profiles of neonates suspected of sepsis at the Greater Accra Regional Hospital from January 2018 to December 2019. Blood culture was done using a fully automated BACTEC 9240 blood culture system. Bacteria isolates were identified by Gram staining and conventional biochemical methods. Antimicrobial susceptibility testing was done by Kirby–Bauer’s disc diffusion method, and interpretations were carried out according to clinical and laboratory standards. Culture and antibiotic sensitivity reports were obtained and the data subsequently analyzed. Results. Of 2514 blood samples collected from neonates suspected of neonatal sepsis, 528 (21.0%) of the samples were found to be culture-positive. The majority of these positive cultures were from male neonates (68.9%). A total of 11 different pathogens were isolated, of which Gram-positive organisms had a preponderance of 72.0% over Gram-negative organisms (28.0%). Staphylococcus epidermidis was the most common pathogen identified, accounting for 60.0% of isolates. The most prevalent Gram-negative bacteria were Klebsiella spp. (13.6%). Most Gram-positive microorganisms showed sensitivity to amikacin, meropenem, vancomycin, and piperacillin/tazobactam. Gram-positive isolates were found to be resistant to ampicillin and penicillin, but moderately susceptible to flucloxacillin. Most Gram-negative isolates were sensitive to meropenem. Conclusion. The prevalence of culture-proven sepsis was 21.0%. The most prevalent Gram-negative bacteria were Klebsiella spp. As there is some level of antibiotic resistance observed in the current study, it is necessary for routine microbial analysis of samples and their antibiogram.

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).…”

Carboxyhemoglobin Levels in Preterm Neonatal Late-Onset Sepsis: To Predict or Not to Predict

“…2 In addition, grampositive microorganisms are far more prevalent than gram-negative organisms in LOS observed in NICUs. 13 However, we found that the causative microorganism for LOS did not predict COHb elevation.…”