Therapeutic Advances in Infectious Disease (Sep 2022)

Bacterial isolates, antibiogram and outcomes of blood culture proven sepsis in neonates at a tertiary institution in South East Nigeria: a cross-sectional study

  • Kenechi O. Nnamani,
  • Chioma P. Nnamani,
  • Kenechukwu K. Iloh,
  • Iloduba N. Aghanya,
  • Simon N. Ushie,
  • Ogochukwu C. Ofiaeli,
  • Chijioke E. Ezeudu,
  • Chinyere U. Onubogu,
  • Ebelechukwu F. Ugochukwu,
  • Comfort N. Akujobi,
  • Clement C. Ezechukwu

DOI
https://doi.org/10.1177/20499361221122479
Journal volume & issue
Vol. 9

Abstract

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Background: Neonatal sepsis (NNS) in developing countries continues to be a diagnostic and management challenge due to the delays in identifying the aetiologic pathogens and antibiograms. Aim: To determine the predominant bacterial isolates, antibiotic susceptibility pattern and outcomes of blood culture proven sepsis in neonates. Methodology: A hospital-based cross-sectional study of 120 neonates admitted into the Special Care Baby Unit (SCBU) of Nnamdi Azikiwe University Teaching Hospital Nnewi with clinical features suggestive of sepsis. A semi-structured questionnaire and proforma were used to record neonatal, maternal and laboratory information. Blood specimens were collected for aerobic culture using Bactenecin (BACTEC)-Ped plus culture system. Antibiotic susceptibility testing was performed using the Kirby Bauer disc diffusion method. Data obtained were analysed using SPSS version 23.0. p value < 0.05 was considered as significant. Results: There were 68 males and 52 females giving a male-to-female ratio of 1.3:1. The median age at admission was 48 h. Staphylococcus aureus 13 (43.3%) was the most common bacteria isolated. The prevalence of blood culture proven sepsis were 25% and 6.7% of the subjects with positive blood culture died. Gram-positive bacteria isolated were sensitive to gentamicin, vancomycin (VA), linezolid and resistant to penicillin. Gram-negative bacteria isolated were sensitive to meropenem (MEM), imipenem (IPM), ciprofloxacin (CIP) and resistant to ceftazidime, ceftriaxone, ampicillin and amoxicillin-clavulanic acid. Conclusion: The most common bacteria isolated causing NNS using BACTEC automated blood culture system was Staphylococcus aureus . The empirical antibiotics considered for use at the study site are gentamycin, VA for Gram-positive organisms and CIP, IPM and MEM for Gram-negative organisms. Some of the participants with positive blood culture died. Therefore, there is a need for regular antibiogram profiles in all hospitals offering neonatal care.