Microbiology of Neonatal Gram-Negative Sepsis in A Level III Neonatal Intensive Care Unit (NICU). A Single Center Experience

Background: Sepsis is still a leading cause of neonatal morbidity and mortality especially when caused by Gram-negative bacteria. The causative organisms and their susceptibility to antibiotics vary among units. Empiric antibiotic therapy is based on the likely pathogens and their susceptibility pattern in a NICU. This study aims to identify, in a cohort of neonates diagnosed with Gram-negative sepsis, the bacteriological profile and the antibiotic susceptibilities as well as to evaluate the appropriateness of the empirical antibiotic coverage.

Material and methods: In this retrospective observational study, all Gram-negative pathogens isolated in the blood culture of neonates admitted to the neonatal unit in a tertiary referral hospital between January 2011and December 2015 were analyzed. Demographic data, causative organisms, antibiotic susceptibility, empiric therapy and outcomes were collected and analyzed.

Results: Of the 2732 neonates admitted to NICU, 80 infants (2.9%) had a blood culture-proven sepsis with a Gram-negative pathogen. Klebsiella pneumonia was the commonest causative organism. Sensitivity to gentamicin and meropenem were 95% and 99% respectively. Mortality, necrotizing enterocolitis, periventricular leukomalacia, bronchopulmonary dysplasia, intraventricular hemorrhage, retinopathy of prematurity was more prevalent in affected infants.

Conclusion: In our unit, neonatal sepsis caused by gram-negative organisms was highly sensitive to aminoglycosides. Almost all cases Gramnegative sepsis were adequately covered by carbapenem.

Key words: Antibiotics resistance; Bacteriological profile; Gram negative; Neonatal sepsis