RESUMEN
Background: The prevalence of healthcare-associated neonatal bloodstream infections is increasing and results in significant morbidity, mortality, and economic cost. The continuous emerging of bacterial resistance to antibiotics worsens the situation and complicates the challenges. The epidemiology of these infections is well studied in developed countries, but the picture is not that clear in developing countries
Objectives: The research aimed to study the epidemiology of late onset neonatal septicemia at the neonatal intensive care unit of Sohag university hospital, the potential predisposing factors for acquiring septicemia, the potential pathogenic bacteria existed in the environment of the unit, and the antibiotic resistance patterns of the isolated bacteria to recommend policy for empirical treatment
Material and Methods: A total of 330 newborns having one or more signs of sepsis, aged from 5 to 28 days, were enrolled in this study. Blood samples were taken from the newborns, cultured, and then antibacterial susceptibility tests were performed for the isolates
Results: 111 [36%] cases yielded positive cultures. Significant positive culture results were found among the group of males [66.67%], preterm [74.36%], with low birth weight [75%], delivered by normal vaginal delivery [67%]. Gram negative bacteria constituted [56%] of the total isolates, of which Klebsiella pneumoniae was the predominant pathogen [23%], followed by Coagulase Negative Sta[hylococci [CoNS][18%]
The mortality rate was 41%. Most bacterial isolates were sensitive to imipenem, and some isolates were sensitive to fourth-generation cephalosporins, but most isolates were highly resistant to the majority of other antibiotics tested. Pseudomonas aeruginosa has shown the highest rate of antibiotic resistance, while Streptococcus pyogenes has shown the least resistance
Conclusion: Potential intrinsic risk factors for septicemia are: preterm, low birth weight and gender [male]. Gram negative organisms were the most frequent causative agents of bacterial sepsis, which is a significant cause of mortality and morbidity in the newborn, and particularly in those of low birth weight. It can also be concluded that imipenem, meropenem and fourth-generation cephalosporins can be used as empirical treatment of bacterial sepsis
Recommendations: Adherence ofhealthcare workers to hand hygiene and personal protective procedures beside appropriate disinfection of the environment are key factors to reduce the acquisition of neonatal septicemia and other infections. This may be achieved by promotion, role modeling and continuous monitoring. Besides that, the availability and accessibility of alcoholic hand-rub solutions will make the difference?