Abstract
Background and objectives: Early and late sepsis in newborns are common causes of early deaths or long-lasting disabilities in infants. They have varied etiologies and death rates. In this survey, the bacterial etiologic agents for neonatal sepsis cases and their antibiotic sensitivity patterns were determined.
Materials and Methods: during 2003-2004, blood samples were collected and processed by culture from 198 newborns who were clinically diagnosed with early sepsis in Western Mazandaran area hospitals. Subsequent to bacterial isolation and identification, disk diffusion antibiotic susceptibility testings were performed according to the NCCLS guidelines.
Results: The study population was 69.7% boys and 38% of them were born with normal vaginal delivery with the rest being C-section delivered babies. The patient risk factors included premature delivery, very low birth weight (<1.5 kg) and Hyaline membrane disease (HMD). The average age of the studied population was 10.53 1.48 days old and the mean length of therapy was 9 days. 63% of these neonates were infected by early sepsis and 37% were infected by late sepsis. The highest death rates (45%) were associated with the very low birth weights. Coagulase negative Staphylococci (34.5%) and Klebsiella pneumoniae (17.2%) comprised the most isolated bacteria. The Gram positive isolates showed the highest sensitivity and resistance rates to vancomycin (96%) and to cloxacillin (65.5%) respectively. The highest sensitivity and resistance rates for the Gram negative isolates were towards ciprofloxacin (95%) and cephalothin (94%), respectively.
Conclusion: The prevalence of early sepsis rates were higher in the boy infants and also in those delivered by C-section operation. The highest risk factor was pre-mature delivery. The high prevalence of antibiotic resistance rates in the isolated bacteria was the major cause of failed therapy and deaths. Adequate pregnancy care in order to reduce pre-mature labor, with considering hygienic principles in hospitals, late sepsis can be avoided and prompt antibiogram tests are measures necessary to reduce morbidity and mortality of early sepsis.