Early Onset and Late Onset of Neonatal Sepsis in a Tertiary Hospital, South-South, Nigeria

Aims: The study was carried out to determine organisms present during early onset of neonatal sepsis (EONNS), late onset of neonatal sepsis (LONNS) and their antimicrobial susceptibility pattern.

Methodology: This study is a retrospective evaluation of 453 neonatal blood cultures. Two (2) ml of blood from these neonates was cultured in thioglycollate broth and tryptone soya broth. This was carried out in the Department of Microbiology and Parasitology of the University of Port Harcourt Teaching Hospital, Nigeria between January-December 2007.

Results: Out of 453, 272(60.0%) neonates showed negative blood cultures, while 181(40.0%) neonates had positive bacterial cultures and 2 neonates (0.4%) were positive for Candida albicans. Overall, Klebsiella spp. was the most common pathogen, accounting for (37.8%) of the total isolates. Others were as follows; Staphylococcus aureus (28.4%), Escherichia coli (11.8%), unclassified coliforms 8.3%, Pseudomonas spp. 4.9%, Enterococcus spp. (2.9%), coagulase-negative Staphylococcus (CONS) (2.5%) and Proteus spp. (3.4%). Early onset neonatal sepsis (EONNS) and late onset neonatal sepsis (LONNS) had Klebsiella spp and Staphylococcus aureus as their common causes of neonatal sepsis respectively. Klebsiella spp. was susceptible to spafloxacin (87.0%) followed by ofloxacin (82.0%), amoxycillin-clavulanic acid (79.0%) and ceftazidime (65.0%) among the Gram-negative organisms. In the category of Gram-positive organisms, Staphylococcus aureus is highly sensitive to ofloxacin (81.0%) followed by spafloxacin (79.0%) and amoxicillin-clavulanic acid (71.0%).

Conclusion: A viable antibiotic susceptibility surveillance programme coupled with good infection control practices and rational antibiotics use will reduce infection rate, ensure better therapeutic success and prolong the efficacy of available antimicrobials.