In vitro antibiotic susceptibility of bacterial pathogens and risk factors associated with culture positive neonatal sepsis  in two hospitals, Katsina metropolis, Nigeria

[1]Obaro, H. K., 1Abdulkadir, B., and 2Abdullahi, S.

1Department of Microbiology, Umaru Musa Yar’adua University, Katsina, Katsina State, Nigeria

2Department of Pharmacology, Umaru Musa Yar’adua University, Katsina, Katsina State, Nigeria

*Correspondence to: [email protected]; +2348136436916

Abstract:

Background: Neonatal sepsis is one of the most important causes of morbidity and mortality among neonates, particularly in developing countries. This study aimed to determine the risk factors and in vitro antibiotic susceptibility patterns of bacterial pathogens associated with neonatal sepsis in Federal Medical Centre (FMC) and Turai Umaru Yar’adua Maternal and Children Hospital (TUYMCH), Katsina, Nigeria.

Methodology: A total of 60 hospitalized neonates evaluated for neonatal sepsis at the special care baby units (SCBU) of the two healthcare facilities whose parents gave informed consent were enrolled for the study between July and December 2020. Blood samples were aseptically collected from the neonates and cultured on BacT/Alert automated platform (BioMérieux, Mercy-Etoile, France) machine. Bacteria were identified from all positive cultures and in vitro susceptibility test was performed on the isolates to determine their minimum inhibitory concentrations (MICs) to eight selected antibiotics using the Vitek-2 compact system. Data were analyzed by SPSS version 22.0. 

Results: A total of 60 neonates with clinical features suggestive of sepsis were enrolled. The mean age of the neonates is 1.35±0.48 days while the mean weight is 2.13±0.89 kg. Neonates with early onset sepsis (<3 days) constituted 65% while those with late-onset sepsis (>3 days) constituted 35%. Thirty-one (51.7%) neonates were culture positive while 29 (48.3%) were culture negative for bacterial pathogens. Gram-positive bacteria predominated, constituting 80.6% while Gram-negative bacteria constituted 19.4%. The most frequent Gram-positive bacteria were coagulasenegative staphylococci (51.6%, 16/31), with Staphylococcus haemolyticus 5 (16.1%) predominating, while the most frequent Gram-negative bacteria isolate was Escherichia coli 2 (6.5%). A high degree of antibiotic resistance (>50% rate) was exhibited by the isolates against most of the tested antibiotics including third generation cephalosporins and fluoroquinolones. Gentamicin was the only antibiotic effective, with 65.5% of all isolates sensitive to it; 68.0% Gram-positives and 50.0% Gram-negatives. Vancomycin was also effective against Gram-positive bacteria, with 68.0% of the isolates sensitive to it. Previous premature delivery (64.5%, 20/31) and baby delivery at home were respectively the only maternal and neonatal factors significantly associated with culture-positive neonatal sepsis (OR=2.975, 95% CI=1.040-8.510). There was no significant difference between culture positive and negative neonatal sepsis with respect to clinical manifestations such as refusal of feeds, fever, jaundice, fast breathing, convulsion and body temperature (p>0.05).

Conclusion: Neonatal sepsis is a substantial cause of mortality and morbidity among neonates admitted at the FMC and TUYMCH, Katsina, Nigeria. There is a need for regular surveillance of the risk factors, causative organisms, and antibiotic susceptibility patterns of isolated pathogens, to inform the choice of empirical antibiotic treatment pending the results of blood cultures.  

Keywords: neonates, sepsis, risk factor, antibiotic, bacteria.

Received Jul 5, 2021; Revised Aug 4, 2022; Accepted Aug 6, 2022

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In vitro antibiotic susceptibility of bacterial pathogens and risk factors associated with culture positive neonatal sepsis in two hospitals, Katsina metropolis, Nigeria