Bacteriological Profile, Antimicrobial Resistance and Outcome of Neonatal Sepsis among Patients at St.Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Date
2021-09
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Addis Abeba University
Abstract
Background: Neonatal septicemia is the presence of clinically associated bacteria or fungi in the
blood of neonate’s .It causes high morbidity and mortality worldwide especially in developing
country.
Objectives: The study was designed to assess the bacteriological profile, antimicrobial resistance
and outcome of neonatal sepsis at St. Paul’s Hospital Millennium Medical College.
Methods: A hospital based cross sectional study design was conducted at St. Paul’s Hospital
Millennium Medical College from March 2020 to July 2020 G.C. Socio-demographic and
clinical data was collected from each patient. 1-2ml of blood was drawn aseptically and
inoculated at bedside on Trypto Soya Broth. Gram stain was performed and subcluturing was
done every other day on blood agar, chocolate agar and Mac Conkey agar plates. For species
identification, colony characteristics and biochemical tests are used if the culture is positive. All
the isolates was tested for susceptibility test by using Kirby-Bauer’s disk diffusion method.
Outcome of neonates was assessed using checklists. Data was encoded in to Microsoft Excel and
analyzed using Statistical Package for Social Sciences (SPSS) version 20 software.
Results: Among 400 study populations, 84(21%) showed bacterial growth, 67 (79.8%) gram
negative and 17 (20.23%) gram positive bacteria. Commonly isolated organisms were Klebsiella
spp 37 (44%), E. coli 19 (21.6%) and Coagulase negative Staphylococci 13 (15.47%) were the
leading causes of neonatal sepsis in our study. Antibiotic resistance was found in both Gram
positive and Gram negative bacteria. Ciprofloxacin and Amikacin were the most effective
antibiotic for gram negative bacteria while for gram positive bacteria Vancomycin, Clindamycin
and Ciprofloxacin were effective drugs.
Conclusion: Bacterial isolates were not giving response to first and second line antimicrobials
that are utilized for the treatment of sepsis in babies who are in the first month of life. Antibiotics
in the third line are moderately successful against isolated bacteria. High utilization rate of
antibiotics is the most important contributory factor for the development of AMR and continuous
surveillance is needed in order to keep national guidelines on antimicrobial therapy updated.
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Keywords
Septicemia, Bacteriological profile, Antimicrobial susceptibility pattern, Blood culture