Antibiotic Susceptibility Pattern of Blood Culture Isolates of Neonates with Sepsis, Ho Municipality

ABSTRACT

Background: Globally, 4 million neonatal deaths occur annually, with one-third of such deaths occurring as a result of infection. In 2011, there were 7.2million deaths in children below 5years globally, and a proportion of 40% of these deaths occurred in neonates. Sepsis was reported to account for one-third of these deaths. Presently, multi drug antibiotic resistance is rapidly increasing in Neonatal Intensive Care Units (NICUs), particularly in developing countries and poses a threat to public health. Blood culture of neonatal sepsis cases in Tamale Teaching Hospital showed 44% positive cases of all samples and Acinetobacter and Klebsiella species showed 100% resistance to ampicillin. The change in these organisms has been reported to vary across regions, between health facilities and even within the same facility. Continuous surveillance is required to inform antibiotic choice for neonatal sepsis management. This study aims at identifying the common causative organisms of neonatal sepsis and their antibiotic susceptibility pattern in the Ho municipality.  

Method: A cross sectional study was conducted, in the Ho municipality from January to May, 2016. A semi-structured questionnaire was used to collect socio-demographic data from mothers of neonates clinically suspected of sepsis. Clinical data of both mothers and neonates were extracted from case notes. Blood was also taken from neonates for culture and antibiotic susceptibility pattern determined. Data was computed into proportions, frequencies and odds ratio using STATA 13.0 software.  

Results: Out of the 150 clinically suspected neonatal sepsis cases, 91 (60.7%) were males. The mean gestational age was 37 weeks (standard deviation ±3weeks) and mean birth weight was 2855.28g (standard deviation ±740.43g). The prevalence of culture positive sepsis was 17.3% of the 150 suspected cases. Gram positive organisms, had a preponderance (69%) over gram negative organisms (31%). Staphylococcus epidermidis was the most common (53.8%) isolate identified. There was a single isolate (4%) each of Proteus mirabilis and Escherichia coli identified. All the isolates identified showed 100% resistance to ampicillin.

Conclusion: The prevalence of culture proven sepsis was 17.3% and Staphylococcus epidermidis was the most common isolate identified. There was a high resistance rate among the pathogens isolated. There is need for ampicillin to be reviewed as first line drug for empirical treatment in neonatal sepsis