Trends in neonatal sepsis: bacteriological profile, and antibiotic resistance pattern at a tertiary care hospital in Egypt

Abstract

Introduction: Neonatal sepsis is a life-threatening bloodstream infection that occurs within the first 4 weeks of life and represents a significant cause of illness and death, especially in developing countries. Regular assessment of the local causative agents and their resistance patterns is important for effective management. This study aimed to determine the microbiological profile of neonatal sepsis and its antibiotic resistance patterns.

Methodology: Our study was conducted on 237 neonates suspected of sepsis. Blood samples were collected and inoculated into BACT/ALERT blood culture bottles. Bacteria causing positive blood cultures were identified conventionally and confirmed to the species level using MALDI-TOF MS. Antibiotic susceptibility patterns were identified using the disk diffusion method in combination with the VITEK® 2 compact system. Data analysis was performed using version 28 of SPSS software.

Results: The overall rate of neonatal sepsis was 33.8% (80/237). Of these, 54 (67.5%) and 26 (32.5%) were caused by Gram-negative and Gram-positive bacteria, respectively. Klebsiella pneumoniae 38 (47.5%) was the dominant causative pathogen, followed by coagulase-negative Staphylococci (CoNS) 24 (30%). Multidrug resistance (MDR) and extensively drug resistance (XDR) were detected in 82.5% and 10% respectively. An alarmingly high incidence of carbapenem-resistance (90.7%) was detected among Gram-negative bacteria. Methicillin resistance was detected in S. aureus and CoNS in 100% and 54.2%, respectively. Tigecycline was the most effective antibiotic for both Gram-positive and Gram-negative bacteria.

Conclusions: Our study showed that neonatal sepsis is mostly caused by MDR pathogens, predominantly Klebsiella pneumoniae, urging revised empirical treatments and stricter infection control measures.