Neonatal sepsis: Incidence, risk factors, common pathogens and antimicrobial pattern in a multiethnic population in Ajman, UAE

ABSTRACT

To determine the incidence, source of infection, impact of gestational age, pattern of delivery, birth weight, feeding pattern on the occurrence of neonatal sepsis and to assess the frequency of pathogens and their antibiotic susceptibility pattern. Medical record review based study was done during Jan-Dec 2011 at GMCH Ajman. Blood was collected aseptically before the administration of antibiotics from 255 sepsis suspected neonates for culture by BACTEC system. The microorganisms isolated were identified by Gram staining and biochemical test; these isolates were further subjected for antibiogram by Kirby-Bauer disc diffusion method. Analysis was performed on SPSS version 20. The neonates were from 28 nationalities, 82% were Asians. Male female ratio was 61 59. The proportion of sepsis was 6.6%; of which male female ratio was 7624. Of the 209 early onset sepsis [EOS] cases 8 were culture proven sepsis, and among the 46 late onset sepsis [LOS] cases 9 were culture positive. Of the culture proven cases, 65% were preterm and 35% were term neonates. Of which 53% were delivered by caesarian section and 47% by vaginal delivery. Thirty five percent were low birth weight, 47% were normal birth weight and 18% were overweight. Eighty eight percent were breast fed, 6% were breast fed along with infant formula and 6% were on IV fluids. Microorganisms isolated were Candida albicans, Staphylococcus species, Streptococcus species and Gram negative bacilli. Gram negative bacilli showed 100% susceptibility towards Amikacin, Augmentin and Ciprofloxacin. Gram positive cocci were 100% susceptible for Azithromycin, Ciprofloxacin and Chloramphenicol. The proportion of sepsis among the suspected neonates was 6.6% with male predominance. Mortality rate was 5.8% among the sepsis proven neonates. Multidrug resistance was not observed among the isolates. The response towards the prophylactic and therapeutic antibiotic regime was effective for the prognosis of sepsis