Background Neonatal sepsis is a global concern with increasing morbidity and mortality. The burden of neonatal sepsis is highest in developing countries, especially in those lacking proper surveillance systems. The causative pathogens and their drug-resistance levels vary between countries with emergence of multidrug resistance organisms. Thus, accurate records on the recent trends of organisms causing neonatal sepsis will provide vital information for appropriate intervention. We aimed to investigate neonatal sepsis, identify its associated factors and causative pathogens and to assess the antibiotic susceptibility patterns in Sana’a city, Yemen. Methods A cross-sectional study was conducted on neonates admitted to intensive care units of six hospitals in Sana’a city, Yemen, in the period from January 15, to March 30, 2020. Natal and prenatal medical data were collected using well-structured questionnaire. Neonates were subjected to sepsis work-up including blood culture, complete blood count and C-reactive protein. Organisms were identified by Gram staining and analyzed by the VITEK II system for bacterial bio-typing and antibiotic susceptibility testing. Findings Of the 199-neonates with suspected neonatal sepsis, 154 (77.38%) had culture-proven sepsis. Early-onset neonatal sepsis (EOS) was higher (50.25%; 100/199) than late-onset neonatal sepsis (LOS) (27.13%; 54/199). Multivariable analysis identified vaginal delivery as an independent risk factor for neonatal sepsis p = 0.005. Majority of isolated bacteria (74.39%) were gram-negative with Burkholderia cepacia (39%) and Klebsiella oxytoca (13%) being the most common pathogens of EOS and LOS. The most common gram-positive pathogens were Staphylococcus haemolyticus (9.1%) and Staphylococcus epidermidis (7.1%). B. cepacia showed multidrug resistance except for cefepime. All Klebsiella species isolates (100%) and most Pantoea species (93%) were ESBL and carbapenemase positive. All Escherichia coli and Acinetobacter baumannii isolates were ESBL positive. A significant number of gram-positive bacteria showed resistance to vancomycin. Conclusion The study findings show a high proportion of neonatal sepsis among neonates admitted to hospitals in Sana’a city with antibiotic-resistant B. cepacia being the single most common pathogen causing EOS and LOS. Findings also emphasize the emerging threat of multidrug-resistant bacteria in neonatal units and will help develop evidence-based management of neonatal sepsis in Yemen.

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Background: Low birth weight (LBW) describes neonates weighing less than 2500 g at birth and is a common obstetric presentation. Therefore, this study determined the risk factors associated with LBW in Sana'a city, Yemen, with a focus on khat chewing during pregnancy. Methods: This case-control study recruited 35 mothers with LBW neonates as cases and 105 mothers with normal birthweight neonates as controls. Data about sociodemographic characteristics, maternal habits, and obstetric characteristics were collected using a pre-designed questionnaire. The association between independent variables and LBW was tested at P-value <0.05. Results: Consanguinity (OR = 3.7, 95% CI: 1.6-8.8; P = 0.005), smoking (OR = 2.6, 95% CI: 1.0-6.6; P = 0.038), history of LBW (OR = 5.0, 95% CI: 2.0-12.8; P <0.001) and family history of LBW (OR = 3.7, 95% CI: 1.6-8.8; P = 0.004) were significantly associated with LBW. However, LBW was not associated with sociodemographic characteristics, khat chewing, or other obstetric characteristics. Conclusions: Consanguinity and smoking are predictors of LBW neonates in Sana'a city. However, khat chewing is not associated with LBW. On the other hand, no significant association exists between LBW and the obstetric characteristics of parity, birth spacing, antenatal care, or frequency of antenatal visits. Yet, a history of maternal LBW and a family history of LBW is associated with LBW. Further large-scale studies are recommended to explo re the risk factors associated with LBW at the community level.