Journal of Clinical & Experimental Pathology
Open Access

Abstract

Neonatal sepsis is a leading cause of morbidity and mortality among both term and preterm infants. With growing antibiotic resistance, this retrospective, descriptive study determined if the current antibiotic regimens used at a tertiary hospital are still effective against the pathogens identified in blood culture in cases of neonatal sepsis from January 1, 2000 to December 31, 2015. Demographic profile, stratification to early- and late-onset sepsis, clinical manifestations, laboratory results, complications and antimicrobial susceptibility of the isolated organisms were analyzed. Prematurity and low birth weight was the major risk factors for developing neonatal sepsis. Respiratory symptoms were the most common clinical manifestations seen. The pathogens were evenly divided between Gram-negative bacilli and Gram-positive cocci, but Gram-negative bacilli had higher mortality rate. The current antibiotic regimen of Cefuroxime and Amikacin for early-onset neonatal sepsis was changed in 57% of cases, indicating that a constant re-evaluation of any regimen is necessary to determine if an antimicrobial upgrade is necessary. Although, Piperacillin-tazobactam has been favored for late-onset sepsis in the unit in the last 15 years, more septic neonates ended treatment on a Carbapenem. There was no growth of ESBL E. coli or Klebsiella pneumoniae in blood isolates in spite of 15 years of current antimicrobial usage practices. A regimen of Cefuroxime and Amikacin for early-onset sepsis will miss a minority of pathogens while a Carbapenem or Piperacillintazobactam, with or without Amikacin, is still effective for late-onset sepsis. Vancomycin should be considered to be added in lateonset sepsis, if Staphylococcal disease is suspected.

Biography

Email: amvmeliton@gmail.com