Early-onset sepsis in a neonatal intensive care unit in Beni Suef, Egypt: bacterial isolates and antibiotic resistance pattern

Abstract

PurposeTo identify the frequency of bacterial isolates in early-onset neonatal sepsis (EONS) and their antimicrobial resistance pattern.MethodsA retrospective study of EONS was conducted at the Beni Suef University Hospital from September 2008 to September 2012. A case of EONS was defined as an infant who had clinical signs of infection or who was born to a mother with risk factors for infection, and in whom blood culture obtained within 72 hours of life grew a bacterial pathogen.ResultsOf 673 neonates screened, there were 138 positive blood cultures (20.5%) (confirmed EONS). Of the recovered isolates, 86.2% were gram-negative pathogens. Klebsiella pneumoniae (42.8%), Enterobacter cloacae (22.5%), and Escherichia coli (13.8%) were the commonest isolated organisms. The most common gram-positive microorganism was Staphylococcus aureus accounting for only 12 isolates (8.7%). All Klebsiella isolates and 93% of Enterobacter isolates were resistant to ampicillin. Gram-negative pathogens had the maximum overall sensitivity to imipenem, cefepime, and ciprofloxacin; whereas, gram-positive isolates were most susceptible to vancomycin, imipenem, and piperacillin.ConclusionK. pneumoniae was the predominant causative bacteria of EONS followed by E. cloacae and E. coli. There was a high resistance to ampicillin. Imipenem had the maximum overall activity against the causative bacteria. Continuous surveillance is needed to monitor the changing epidemiology of pathogens and antibiotic sensitivity.

Plasma myeloperoxidase enzyme assay in cases of neonatal sepsis

“…These differences may be attributed to large sample size (11,790 neonates) compared to our sample size. In agreement with the study of Fahmey, the highest frequency pathogen among culture-proven cases was for Klebsiella that was isolated from 41.5% neonates in our study and 42.8% in the comparative study [14].…”

Bacteriological profile and antimicrobial sensitivity pattern in neonatal sepsis: a study from North India

“…Third generation cephalosporin resistance is now rampant and has been widely reported by recent studies. 3,4,7,8,10,15,16,17 Ceftizoxime revealed better sensitivity pattern against Pseudomonas aeruginosa (57%) in index study when compared to a recent study (25%). 18 Pseudomonas was sensitive to ciprofloxacin in only 47% isolates in our study as against reported sensitivity of 75% by Kumhar. 12 Recent studies reported increased resistance of Pseudomonas to ciprofloxacin varying from 10% to 40.8%.…”

“…3 Whereas, many studies reported Klebsiella to be the most common organism. 4,[6][7][8][9] Some authors had found Staphylococcus aureus as the most common organism. 10,11 Intrapartum antibiotic prophylaxis has also led to a substantial change in the bacterial flora responsible for early onset neonatal sepsis.…”

Etiological profile of early neonatal bacterial sepsis by multiplex qPCR

“…This prevalence, as well as the finding that S. aureus was the most commonly found Gram-positive bacteria, confirms the findings described by Zaidi et al [25] in their study of neonates with ENS in Latin America, the Caribbean, Asia, and Africa. In Brazil, the study by Paes et al [26] and Silva et al [27], both held in Pará State, also demonstrated a prevalence of Gram-negative bacteria among patients with ENS, which was also observed by Fahmey [28] in India; however, in the latter study, K. pneumoniae was the predominant bacteria found. The study by Sharma et al [29] also demonstrated that S. aureus and E. coli were among the main bacteria found in ENS.…”