Evaluation Of Culture-Proven Neonatal Sepsis At A Tertiary Care Hospital In South Africa

Abstract

Background: Organisms causing neonatal sepsis differ in different regions and change over time in the same area. The antibiotic susceptibility of microorganisms also changes, with emergence of multidrug resistant organisms.

Aim: This study aimed to review the causes of neonatal sepsis and antibiotic sensitivity of organisms causing neonatal sepsis at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) neonatal unit over a 12-month period.

Methods: This was a retrospective descriptive study. All blood cultures obtained from the neonatal unit at CMJAH between 1 January 2012 and 31 December 2012 were reviewed. This was followed by a review of clinical data of patients with a positive culture.

Results: During this time there were 196 patients with blood-culture proven neonatal sepsis (NNS). This gave an incidence of 10.326 per 100 admissions. Late-onset sepsis (LOS) accounted for 83.7% of cases of NNS. Predominant isolates were Klebsiella pneumoniae (32.2%), coagulase- negative staphylococci (23.72%) and methicillin-resistant Staphylococcus aureus (13.13%). The majority of the isolated K. pneumoniae were extended beta-lactamase-producing (ESBL) with resistance to ampicillin and gentamicin.

Conclusion: Neonatal sepsis is a common problem at CMJAH neonatal unit. There has been an increase in the predominance of gram-negative microorganisms as a cause of NNS in the CMJAH neonatal unit over recent years, with ESBL Klebsiella pneumoniae and Acinetobacter baumannii being the most prevalent. Coagulase negative staphylococcus remains an important cause of NNS, and is the most prevalent gram- positive organism isolated. Resistance to commonly used antibiotic regimens is high.