Bacterial Isolates, Drugs Susceptibility Pattern and Associated Factors of Neonatal Sepsis in Dire Dawa, Eastern Ethiopia

Abstract

Neonatal sepsis is characterized by bacteraemia in the first four weeks of life. It is the third most common cause of death in this age group with an estimated 401,000 of deaths in 2015, the vast majority of which are in developing countries. Objective of this study was to determine bacterial isolates, drugs susceptibility pattern and associated factors of neonatal sepsis in Dire Dawa. Cross-sectional study design was employed to collect relevant information using structured check list and about 1ml of blood specimen for culture was drawn from 396 newborn admitted in the neonatal intensive care unit of the hospital during the study period. The specimen was inoculated into brain heart infusion broth and subcultures were performed. The isolates were identified by standard biochemical tests. Antimicrobial susceptibility pattern was studied by Modified Kirby Baur Disc diffusion technique. The data was entered using Epidata version 3.1 & analyzed using SPSS 16.0 software. Bivariate and multivariate logistic regression analysis was performed to evaluate whether individual predictors of interest were independently significantly associated with sepsis. Sepsis was confirmed in 127 neonates (32.10%). Gram negative bacteria dominated the isolates (67.72%) in which K. pneumoniae (34.66%) was the commonest isolate followed by S. aureus (22.83%) from gram positive bacteria. This study also identified infection due to MDR bacteria (77%) that the main isolates, S. aureus (83%) and K. pneumoniae (84%), were the principal MDR strains. Gram positive and gram negative bacteria isolates showed 65%- 85% resistance rates to ampicillin, amoxicillin-clavulanic acid, tetracycline, and ceftriaxone. Gentamycin (93% sensitive) and ciprofloxacin (71% sensitive) were effective against gram positive bacteria; whereas gram negative bacteria were 100% sensitive to ciprofloxacin. Predisposing factors associated with neonatal sepsis were prematurity (AOR = 3.243: 1.534, 6.856), age less than 3 days (AOR = 2.654: 1.483, 4.746), low birth weight (AOR = 4.684: 2.319, 9.460), assisted vaginal delivery (AOR = 3.322: 1.462, 7.549), and resuscitation (AOR = 3.592:1.904, 6.778). This study demonstrated that prematurity and low birth weight were major predisposing factors to neonatal sepsis mainly caused by K. pneumoniae and S. aureu. Implementation of bundle of cares based strategies and regular evaluation is advised.