Rising cases of MRSA infection in neonates- a major concern and a call for action.

Abstract

Introduction:Neonatal sepsis is still a global health concern as it contributes to high burden of neonatal morbidity and mortality especially in developing countries. The aim of the study is to give an insight into neonatal sepsis: risk factors, sepsis types, clinical features, pathogen burden with their antibiotic sensitivities and outcome of admission in our facility. Methodology: This was a prospective hospital-based study involving term neonates suspected of having sepsis conducted over 10 months, October 2018-July 2019. Sociodemographic information and clinical characteristics were gathered using a structured questionnaire. Venous blood samples were obtained for complete blood count (CBC) and blood culture. MicrobactTM 24E (Oxoid UK) and Staph ID kits were utilized to identify the organisms based on manufacturer guidelines. Antimicrobial susceptibility testing (AST) was conducted using the modified Kirby-Bauer disk diffusion method. Data analysis was performed using SPSS version 22 and results were presented in tabular format. Result: Of the 248 term neonates with features of sepsis were enrolled into the study, out of which 94 (37.9%) were confirmed to have sepsis. Late-onset sepsis LOS (68%) was found to be the most common and most of the neonates were delivered elsewhere. Clinical features were non-specific for both early-onset (EOS) and LOS and include fever, jaundice, poor suck and depressed primitive reflexes. Infections were mostly caused by the gram-negative bacteria and Staphylococcus aureusis the single most common isolate for both EOS and LOS. Antibiotic sensitivity is highest with ciprofloxacin for both EOS and LOS. Mortality is high 14.9% and is mostly contributed to by Staphylococcus aureus infection. Conclusion:Neonatal sepsis is still a burden with mostly non-specific clinical features. The local prevalent organisms are Staphylococcus aureus, Enterobacter agglomerans and Klebsiella pneumonia with good antibiotic susceptibility to ciprofloxacin. Most presented with late onset-sepsis and therefore infection is likely to be community-acquired which to a great extent can be prevented with robust public health interventions.