Bacteriology and Outcome of Neonatal Septicaemia: Experience from a Mission Hospital in Nigeria

Abstract

Introduction. One in every three preventable under-five deaths occur in the neonatal period and one of the leading causes of neonatal death in Low and Middle-Income Countries (LMIC) is sepsis. Organisms isolated varies between and within geographical locations, its trend changes with time. Each setting hence needs to have its antibiogram for susceptible isolates to optimize treatment outcome, the background on which this study was conducted.

Methodology. A retrospective study was done on neonates admitted to the Neonatal Intensive Care Unit of Bowen University Teaching Hospital, a missionary hospital in South West Nigeria, between January 2016 and December 2017. The medical records of these neonates were retrieved from the comprehensive electronic database for all neonates admitted into the unit.

Result. Of the 129 newborns eligible for the study, early-onset sepsis (56.6%) predominated. There were 79 (61%) males giving a M:F ratio of 1.6:1. The incidence rate of neonatal sepsis was 15 per 1,000 live births with a mortality rate of 24%. Gram-Negative Bacilli were mostly isolated in positive cultures. The likelihood of getting a positive culture was unrelated to the age and sex of patients at presentation. There was a varying resistance pattern of the isolates to commonly used empiric antibiotics.

Conclusion and Recommendation. Gram-Negative Bacilli was the commonest cause of neonatal sepsis in our center, associated with poor outcome. The high incidence of resistance to the commonly used empirical treatment calls for an urgent review of practice if the trend of high morbidity and mortality would be curtailed, as well as improved infection control practices.