Causative Microorganisms and Antibiotics Susceptibility in Neonatal Sepsis at Neonatal Intensive Care Unit: A Longitudinal Study from Diyala Governorate in Iraq

Abstract

Background: Neonatal sepsis is classified into two types, early-onset and late-onset sepsis, depending on
the time of appearance of the clinical features of neonatal sepsis.
Objective: We aim to detect the most common causative organisms of neonatal sepsis and to evaluate the
corresponding antibiotics susceptibility in the Diyala governorate.
Patients and Methods: We prospectively collected a convenient sample of 106 sepsis-proven neonates
from the neonatal intensive care unit at Al-Batool teaching hospital. We assessed all cases based on clinical
features, laboratory investigations, and demographics.
Results: Late-onset neonatal sepsis was predominant (77.4%) among neonates, and it was significantly
associated with neonatal prematurity and the mode of delivery at p-values of 0.03 and 0.045 respectively.
Premature neonates and those who were the product of cesarean section were more prone to develop
late-onset neonatal sepsis with a relative risk of 2.8 and 2.54 respectively. The most common causative
microorganism of early-onset neonatal sepsis was found to be Escherichia coli in 45.8% of cases while
those causing late-onset neonatal sepsis were mainly due to Gram-negative bacilli represented by Klebsiella
pneumonia (46.3%) and Acinetobacter baumannii (24.4%). Multi-drug resistance was evident for most of
the causative microorganisms.
Conclusion: To recapitulate, late-onset sepsis appeared was more common among Iraqi neonates, and it was
significantly associated with the neonate prematurity and C-section mode of delivery.