Characterization of Neonatal Sepsis in a Tertiary Hospital in Nigeria

T.O. Obadare, 1 E.A. Adejuyigbe, 2,3 A.T Adeyemo,1 O.A Aboderin 1,4
1. Obafemi Awolowo University Teaching Hospitals Complex, Medical-microbiology and Parasitology, Ile-Ife, Nigeria 2. Obafemi Awolowo University, Peadiatrics and Child Health, Ile-Ife,
Nigeria, 3. Obafemi Awolowo University Teaching Hospitals Complex, Neonatology Unit, Ile-Ife, Nigeria 4. Obafemi Awolowo University, Medical-microbiology and Parasitology, Ile-Ife, Nigeria

PURPOSE METHODS & MATERIALS RESULTS

 Neonatal sepsis is a major public health issue  Of the 763 neonates admitted during the study, 192 were clinically diagnosed sepsis among
with attending morbidity with more brunt in  A descriptive cross-sectional study from December which 82 (42.7%) had positive blood culture.
developing countries.1 2017 to April 2019.
 Bacterial etiology of neonatal sepsis were Staphylococcus aureus 85.7% (42/82) Coagulase-
 High neonatal mortality is attributable to Specimen Processing negative Staphylococcus spp 20.7% (17/82), Enterobacter spp 9.7% (8/82) Acinectobacter spp
neonatal sepsis (Figure 1).2 6.1% (5/82) and Stenotrophomonas maltophilia 3.7% (3/82).
 This study determined the epidemiology and PCT Assay  There is high level of resistance to the World Health Organization recommended first line
bacteriological characteristics of neonatal antibiotics among bacteria agent of neonatal sepsis: for Gram negative bacilli, ampicillin
sepsis. Blood Data Collection 88.9% (8/9), ceftriaxone 75.0% (12/16), gentamicin 40.0% (6/15); among catalase positive
Gram positive cocci, penicillin (surrogate for ceftriaxone and ampicillin) 98.3% (58/59) and
gentamicin 61.0% (36/59).
Bacterial identification
Demography  There is high proportion of MDR3-bacterial infection including MRSA 85.7%(36/42), MRCoN
Clinical Data 52.9% (9/12), ESBL 22.2% (4/18) , AmpC 22.2% (4/18), and carbapenem resistance 31.3%
Antibiotic susceptibility (5/18).
Testing test Statistical analysis
 Respiratory rate of ≥60cpm (FE=5.16; p=0.03), reduced movement (FE=7.76; p=0.00) and
grunting (FE=4.68; p=0.04) were associated with positive blood culture.
Fishers Exact
PCR Chi- square  Independent risks for neonatal mortality were elevated serum procalcitonin (X2 =13.58; p=
Logistic regression 0.03), Gram-negative bacteremia (X2=24.64; p=0.00) and low birth weight (≤2500g);
X2=13.58; p=0.03].
CONCLUSION
Figure 1  There was high resistance to World Health Organization (WHO) recommended antibiotics for
neonatal sepsis and this calls for concern and review in our setting.
REFERENCE  Serum procalcitonin assay prognosticates neonatal sepsis and its utilization could be
1.Qazi SA SJ. Neonatal Sepsis A Major Global Public Health Challenge. Pediatr Infect Dis J. 2008;28(1):S1–2., 2. Drugs for Neglected Diseases initiative. Global antibiotic institutionalized in low- and middle-income countries.
research & development partnership (GARDP). 2016.,3. Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pan drug-
resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18:268–81 ACKNOWLEDGMENT: Funding by ISID grant CONTACTS: gratus09@yahoo.com ; +2348064167371