Neonatal sepsis: a two-year review of the antibiograms of clinical isolates from the neonatal unit

Background: Neonatal Sepsis is one of the leading causes of morbidity and mortality in Neonatal Intensive Care Units. Identifying the most common organisms and their susceptibility patterns improve the management of infections

Objective: To evaluate the incidence of Neonatal Sepsis and to identify the most common organisms, their sensitivity patterns to antimicrobials and to formulate future empiric therapy for patients

Design: A Retrospective Study

Setting: NICU, King Hamad University Hospital, Bahrain

Method: Patients admitted to the NICU from 1 July 2013 to 30 September 2015 were reviewed. Sixty-seven patients with positive blood cultures were suspected to have sepsis. Early Sepsis, 18 [26.9%] and late Sepsis, 49 [73.1%], were included in the study. Patients with contaminated blood cultures, cultures with mixed growth and those have been referred from other hospitals with external blood culture reports were excluded. The following data were documented: culture and sensitivity, antibiotics used, neonatal and maternal risk factors and severity of sepsis and the outcome

Result: Sixty-seven neonates were included in the study, 34 [50.7%] were males. The incidence of early onset neonatal sepsis compared to late onset neonatal sepsis was 26.8% and 73.1%, respectively. The most common pathogenic organism was Coagulase-Negative Staphylococci [CONS] in 32 [47.7%] neonates, followed by gram-negative bacilli in 17 [25.4%] neonates. Coagulase Negative Staphylococci species were susceptible to Tazocin and Linezolid. The gramnegative bacilli were mainly sensitive to Amikacin and Imipenem along with Tazocin. All Group B Streptococcus cultures were sensitive to Ampicillin compared to approximately 57 [85%] only being sensitive to Vancomycin, Linezolid and Penicillin

Conclusion: This is the first study in our NICU. The study revealed the organisms seen in the unit, their sensitivity patterns and the antibiotics used compared to what should be used. This study provides a foundation to improve the standard of care for neonatal Sepsis

case of pneumoperitoneum secondary to pneumatosis intestinalis: is surgery always indicated?

Pneumatosis intestinalis [PI] is a rare condition, which could be associated with a spectrum of disorders that vary from mild to life-threatening. We report a case of an eighty-five-year-old male who presented with abdominal distension and vomiting. Examination revealed the presence of peritoneal signs, with abdominal and pelvic CT confirming PI of the small bowel, a relatively rare condition. The patient underwent an exploratory laparotomy, during which, a segment of the terminal ileum was resected and an ileostomy was fashioned. The patient, unfortunately, died one month postoperatively due to postoperative complications. This case demonstrates the need for risk stratification guidelines to decide conservative or surgical management in cases of PI in this age group