Causative Organisms, Antibiotic Sensitivity Patterns and Risk Factors Associated with Neonatal Sepsis at Moi Teaching and Referral Hospital, Kenya

Abstract

BackgroundNeonatal bacterial infections have been associated with rising antimicrobial resistance levels. This has led to increasing neonatal morbidity and mortality in poorly resourced health facilities located in low income countries. Local studies on neonatal antibiotic sensitivity patterns and its associated risk factors could inform empirical antibiotic therapy and hospital infection control strategies.PurposeThe study aimed at determining the causative organisms, antibiotic sensitivity patterns and risk factors associated with neonatal sepsis at a tertiary teaching hospital in Western Kenya.Materials and MethodsCross-sectional study among neonates suspected to have sepsis and undergoing treatment at Moi Teaching and Referral Hospital (MTRH’s) newborn unit (NBU) between September 2017 and July 2018. Blood culture tests isolated bacteria and determined their antimicrobial sensitivity. Neonatal and maternal characteristics were obtained through medical chart reviews. Descriptive statistics, Pearson chi-square test of association and odds ratios were adopted.ResultsThe study enrolled 141 neonates, majority (57.4%) of whom were female. The median gestational age and birth weight were 37 (IQR: 22-45) weeks and 2400g (IQR: 800 - 4700) respectively. Of the 151 bacterial isolates identified, 46.4% were Klebsiella spp. followed by Coagulate negative staphylococcus (CoNS) at 27.8%. Klebsiella spp. was sensitive to meropenem, amikacin and cefepime but resistant to ceftriaxone, gentamycin and cefotaxime. However, CoNS was sensitive to vancomycin and penicillin. Both the neonatal and maternal risk factors assessed were not associated with neonatal sepsis.ConclusionThe main bacterial causes of neonatal sepsis were Klebsiella spp. and CoNS which were both sensitivity to meropenem and amikacin.

Silent threats on surfaces and equipment in the newborn unit of Kenyatta National Hospital in Kenya

“…Nosocomial infections are a major cause of severe morbidity and mortality in hospitalized newborn infants [1,2]. They adversely affect preterm or term infants in intensive care units.…”

“…They adversely affect preterm or term infants in intensive care units. Approximately 70% of hospital-acquired infections manifest as bacteremia and neonatal sepsis [2,3]. Almost a third of neonates in the newborn unit (NBU) at Kenyatta National Hospital (KNH) get neonatal sepsis [4].…”

“…Methicillin-resistant Staphylococcus aureus (MRSA) and Klebsiella spp. resistant to ceftriaxone, cefotaxime, and gentamicin were also implicated in a study of neonatal sepsis at Moi Teaching and Referral Hospital (MTRH) in Kenya [2].…”