Retrospective review of bacteriological profiles and antibiogram in a tertiary neonatal unit

Abstract

Background: Neonatal sepsis remains a major cause of morbidity and mortality. Therefore, early detection and initiation of appropriate empirical antibiotic therapy are crucial. Objectives: The aim of this study was to describe the antibiogram of the neonatal intensive care unit at Grey’s Hospital, a tertiary hospital in KwaZulu-Natal. Method: This was a retrospective descriptive study, reviewing positive cultures from Grey’s Hospital tertiary neonatal intensive care unit (NICU) in KwaZulu-Natal, South Africa for a 3-year period (01 January 2017 to 31 December 2019). All positive cultures from all sites were included. Results: There were 1314 positive organisms cultured. Late-onset sepsis (89.3%) predominated over early-onset sepsis (10.7%). Blood was the source for 55.2% (725/1314) of positive cultures. Of the 1314 organisms cultured, 53.7% (706/1314) were Gram-positive, 45.7% (601/1314) were Gram-negative and 0.5% (7/1314) were Candida species. Klebsiella pneumoniae, 23.5% (313/1314) was the most frequent Gram-negative organism. It was noted to have high resistance to the unit’s first-line antibiotic regimens; 99% were resistant to ampicillin and 92% resistant to gentamicin. Conclusion: Blood cultures yielded most positive results with a predominance of Gram-positive organisms and late-onset sepsis. A significant proportion of the cultured organisms were resistant to the first-line antimicrobials utilised in the unit, ampicillin and gentamicin. Contribution: Ongoing surveillance on positive cultures is recommended to assess the effectiveness of the unit’s current empirical antimicrobial guideline.

Keywords

• neonatal sepsis
• neonatal mortality
• antibiotic susceptibility
• antibiotic resistance
• empirical antibiotics