Background: Antimicrobial-resistant pathogens are of increasing concern in the neonatal intensive care unit
population. A myriad of resistance mechanisms exist in microorganisms and management can be complex
because broad-spectrum antibiotics are increasingly needed.
Objective: To study the bacterial pathogens causing neonatal sepsis and their
sensitivity pattern so that guidelines can be prepared for empirical antibiotic therapy.
Setting: The study was conducted in the neonatal intensive care unit (NICU) of sohag university hospital in
the period between August 2010 and August 2012.
Methods: Blood specimens for culture were drawn from 330 newborns admitted in the NICU of Sohag
University Hospital. The specimens were inoculated into WAMPOLE ISOLATOR 1.5. The antibiotic
susceptibilities of the isolates were determined by the disk diffusion method on Mueller–Hinton agar plates
using calibrated inoculum of the isolates based on McFarland turbidity standard according to the Clinical
Laboratory Standards Institute. The antibiotic resistance pattern of the isolates was studied by modified Kirby
Bauer disc diffusion technique as well as E test.
Results: A total of 117 organisms were isolated. These included Klebsiella pneumoniae accounted for
(23.07%) of the total isolates followed bycoagulase negative Staphylococci(CoNS) which accounted for
(17.94%), then Pseudomonas aeruginosa (15.38%), followed by Staphylococcus aureus which accounted
for (12.82%), while Esch. coli accounted for (10.25%), then Enterococcus faecalis and Burkholderia cepacia
each accounted for (7.69%), finally Streptococcus pyogenes with a percentage of (5.12%). Most bacterial
isolates were sensitive to imipenem and some isolates were sensitive to fourth-generation cephalosporins,
but most isolates were highly resistant to the majority of other antibiotics tested. Pseudomonas aeruginosa
and Burkholderia cepacia have shown the highest rate of antibiotic resistance, while Streptococcus
pyogenes has shown the least resistance. Phenotypic prevalence of extended spectrum beta lactamase
(ESBL) producing gram negative bacteria was 75%, while Prevalence of Methicillin resistant Staphylococcus
aureus (MRSA) 80%, Prevalence of methicillin resistant coagulase negative Staphylococci (MRCoNS) 78%
and Prevalence of vancomycin resistant enterococci(VRE) was found to be 33%.
Conclusion: Control and prevention of antibiotic-resistant organisms require an interdisciplinary team with
continual surveillance. Judicious use of antibiotics; minimizing exposure to risk factors, when feasible; and
effective hand hygiene are crucial interventions to reduce infection and transmission of antibiotic resistant
organisms (AROs).