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

uncommon diagnosis of Windsock deformity for a common presentation

We report a two-year-old Indonesian female who presented with vomiting and weight loss for more than one month and was ultimately diagnosed with duodenal obstruction due to a windsock deformity. This is a rare and intrinsic congenital anomaly of the duodenum. The diagnosis as well as immediate and conclusive surgical management is discussed