Characteristics of neonatal Sepsis at a tertiary care hospital in Saudi Arabia

Abstract

Aim: To identify the risk factors, laboratory profile, microbial profile, mortality and complications, mortality causing organisms and antimicrobial susceptibility patterns of neonatal sepsis at a tertiary care hospital. Methods: A retrospective study was conducted using the neonatal intensive care unit (NICU) database in King Fahad Medical City (KFMC), Riyadh, Saudi Arabia. All neonates born in KFMC with clinically diagnosed sepsis in the NICU were included in this study. Results: During the study period, a total of 245 neonates with a culture-proven diagnosis of neonatal sepsis were included in this study and 298 episodes of sepsis were observed. Out of the 298 episodes, EOS occurred 33 (11.1%) times, and LOS occurred 265 (88.9%) times. For both neonates with EOS and LOS prematurity was the major neonatal risk factors for sepsis 16 (48.5%), 214 (80.8%); respectively. Multiparty and delivery by caesarean section were the top maternal risk factors of both EOS and LOS. Nneonates with LOS had high CRP, Total WBC count and thrombocytopenia compared to EOS neonates. Our results showed that in the EOS neonates, GBS was the most common pathogen followed by Escherichia Coli. In LOS neonates, the common organisms were Staphylococcus spp., Klebsiella and Pseudomonas aeruginosa. Mortality rate of neonatal sepsis is higher in EOS 5 (15.2%) from total EOS compared to LOS 24 (11.3%) from total LOS. All Gram-negative bacteria were sensitive to Amikacin. Gram-negative non-fermenting bacteria, such as P. aeruginosa and Acinetobacter were sensitive to amikacin and gentamycin. All Gram-positive bacteria were sensitive to gentamycin. Among thirteen Candida albicans isolates, 85% were sensitive to fluconazole. Conclusion: Concerted efforts are needed to determine the spectrum of risk factors and the clinical characteristics of EOS and LOS in order to implement appropriate treatment strategies as sepsis remains to be a serious danger to neonatal wellbeing. Moreover, our study emphasizes that use of aminoglycosides is much agreeable as compared to the broad spectrum antibiotics which are more rampantly used nowadays. Keywords: Neonatal sepsis, Neonatal intensive care unit, Saudi Arabia