Neonatal Septicemia in Neonatal Intensive Care Units: Epidemiological and Microbiological Analysis of Causative Organisms and Antimicrobial Susceptibility

Al-Talib, Hassanain; Al-Khateeb, Alyaa R.; Al-Khalidi, Rakan
February 2013
International Medical Journal;Feb2013, Vol. 20 Issue 1, p36
Academic Journal
Background: Neonatal septicemia (NNS) is a major cause of death in newborns despite sophisticated intensive care. This retrospective study described the epidemiology of NNS, evaluated the impact of risk factors on the NNS cases and mortality rate, and determined the bacteriological profile and antibiotic sensitivity pattern of NNS in neonatal care units. Methods: This study was done in four referral hospitals located in north Iraq for a period of 2 years. Hospital records of all neonates with positive blood cultures were reviewed retrospectively. Neonates were divided into those with onset of sepsis in the first 7 days of life (early-onset group) and those with onset after 7 days of life (late-onset group). Epidemiology, risk factors, outcomes, causative pathogens, and antibiotic sensitivity pattern of early and late-onset NNS were compared. Results: The estimated incidence rate of NNS was 5.7/1000 live birth, with both proportional morbidity rate and fatality rate of 9%. In early-onset group, a low Apgar score at 5 min, and prolong rupture of membrane were significantly higher, while younger gestational age was significantly higher among late-onset group. The most frequently isolated bacteria were coagulase- negative staphylococci and 5. aureus. Gram positive organisms displayed a high degree of resistance to most penicillins and cephalosporins but vancomycin and imepenem were effective in them. There was a high resistance rates noted with most third generation cephalosporins and aminoglycosides amongst most Gram negative organisms where amikacin and imepenem were effective in most cases. Conclusions: The knowledge of the prevailing strains, the epidemiologic and microbiologic characteristic of NNS remain the keystones for management of this nosocomial infection, and is essential to meet the challenge of NNS with equal proficiency and opposing force.


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