Bacterial Profile and Antimicrobial Susceptibility in Neonatal sepses, Al -Alwyia Pediatric Teaching Hospital in Baghdad

Abstract

Background: Neonatal septicemia is a major health problem in developing countries furthermore data on bacteriological profile in early onst sepses (EOS) and late neonatal sepsis (LOS) are lacking in context of  continuous change in bacteriological profile and increasing resistant strains. Objectives: The study done to determine the pattern of organisms implicated in neonatal septicemia in a neonatal care unit and to measure the degree of bacterial resistance to some antibiotics.

Type of the study : cross –sectional study.

Methods: Confirmed cases of neonatal septicemia admitted at Al-Alwyia pediatric teaching hospital for the period from January 2011- January 2012 were included which constitute 107 case. Blood samples were obtained, incubated and Subculture was done on blood agar and MacConkey Agar routinely after 48 hours and 7 days and in between if visible turbidity appeared. Bacterial isolates and antibiotic sensitivity   were identified by standard conventional methods.

Results EOS constituted  29.9%(32 case) of  confirmed neonatal sepsis , while LOS constituted 70.1% (75case) .Eescehrichia coli (E. coli) constitutes 37% of EOS followed by Klebsella pneumonia and Staphylocoocus species (which constitute 12.5% for each of them ) were the most common microorganisms, while for LOS: E.coli constituted 38.7 % of LOS followed by Staphylocoocus species 17.3% and Klebsella pneumonia 10.7%. Gram negative (G negative) bacteria predominated over gram positive (G positive) bacteria in both EOS (81.2%) and LOS (74.7%) .  Staphylocoocus species predominates G positive   sepsis in both EOS and LOS. Group B streptococci are not identified in the study sample. Microorganisms tested shows highly resistant to amoxicillin or ampicillin and to gentamycin.For amoxicillin or ampicillin higher resistant (100%) were encourted with pseudomonas, proteus and Enterobacter. For cefotaxime high rate of resistance encountered with klebsella (71.4%) compared to 40% resistant in pseudomonas. Amikacin also shows varied degree of resistant for E. coli(22% ) and klebsella (41%) , pseudomonas(10%)  ,and  Enterobacter (16.7%) .for Staphylococcus aureus, proteus and citrobacter no resistance was encountered to amikacin and the  sensitivity was 100% in tested isolates .

Conclusions:   G negative bacteria is more common in EOS and LOS with predominant of E. coli in two categories .Resistant strains to commonly used antibiotics is a common finding.  Guidelines in treatment of neonatal sepsis should be frequently reviewed taking in consideration antimicrobial resistance .  Due to magnitude of problem, preventive measures for EOS and LOS should be considered.