Incidence, bacteriological profile and antibiotic sensitivity pattern of neonatal sepsis in a tertiary health facility in Abuja, North-central Nigeria.

Background: Neonatal sepsis is commonly caused by bacteria in the first 28 days of life. If prompt management is not instituted, it could lead to death within hours of onset. Due to diagnostic limitation in developing settings, prompt laboratory identification of causative organism is usually a challenge. To prevent mortality, clear knowledge of bacteria and their antibiotics sensitivity pattern is important for prompt empirical treatment. Methods: This prospective and cross-sectional study enrolled 339 newborns and were admitted for probable sepsis to the special care unit of the university of Abuja Teaching Hospital. Socio-demographic profile and Blood culture was done from every enrolled newborn using BACTEC 9050. The pattern of the clinical features, incidence, bacteriological profile and antibiotic sensitivity pattern of newborns with confirmed neonatal sepsis were documented. Results: A total of 645 newborn were admitted for probable sepsis during the study period based on clinical features and initial laboratory work-up. Forty-six of the 645 newborns (46/645) had laboratory confirmed sepsis based on blood culture resulting in a neonatal sepsis incidence rate of 71.3 (95%CI 50.7-91.9) per 1000 admitted newborn. Seventeen of the 46 confirmed sepsis cases were among the 1322 newborns delivered within the study facility during the study period giving an in-hospital neonatal sepsis incidence rate of 12.9 (95% CI 6.7-19.0) per 1000 live birth. Amongst the 46 babies with positive blood culture, 27/46 (58.7%) had normal white cell count while the remaining 19/46 (41.3%) had abnormal results. In all, 52 counts of bacteria categorized into 11 bacteria species were isolated from the 46 positive blood cultures. Enterococcus spp and streptococcus species were the commonest gram-positive while Escherichia coli and Chryseomonas luteola were the commonest gram-negative bacteria isolates. Imipenem (all bacterial isolates except Vibrio fluvialis), Augmentin (Streptococcus spp, Staphylococcus spp, Escherichia spp, Enterococcus spp, Klebsiella spp, Moraxella catarrhalis, Acinetobacter baumannii), Vancomycin (Streptococcus spp, Staphylococcus spp, Escherichia spp, Enterococcus spp), and Ofloxacin (all except Vibrio fluvialis and Citrobacter freundii) had the widest coverage of bacteria isolated from newborn with sepsis. Conclusion: Sepsis in newborn is still prevalent in our environment and compared to previous documented isolates and sensitivity pattern, the bacteria causes, and their antibiotic sensitivity patterns appears to be changing.