Bacterial Etiology and Antibiotic Resistance Patterns in Neonatal Sepsis in the West of Iran.

Abstract

Background: Antimicrobial resistance is an important public health issue worldwide, which is prevalent in developing countries such as Iran. The present study aimed to assess the bacterial sepsis and patterns of antimicrobial susceptibility in neonatal sepsis.Methods: This cross-sectional study was conducted on 430 neonates with the clinical suspicion of septicemia, who were admitted to the neonatal intensive care unit (NICU) of Beasat Teaching and Referral Hospital in Sanandaj, Kurdistan, and west of Iran from May 2018 to April 2019. Data analysis was performed using the WHONET software version 5.6, and the research units were described based on frequencies and proportions.Results: From a total of 430 neonates, 41 blood cultures were positive. Early onset sepsis (EOS) and late onset sepsis (LOS) were detected in 17(41.5%) and 24 (58.5%) cases, respectively. Coagulase-negative Staphylococci (CONS) and Acinetobacter spp. were identified in 18/41 (43.9%) and 7/41(17%) isolates as the most predominant species. CONS and Acinetobacter spp. had the highest resistance against ampicillin (13; 72.2% and 5; 71.4% respectively). In addition, Gram-negative and Gram-positive bacteria both showed resistance to third-generation cephalosporins, while multidrug resistance was observed in 22 isolates (53.7%). On the other hand, the isolates of Gram-positive bacteria exhibited more efficient susceptibility patterns against third-generation antibiotics, such as clindamycin, vancomycin, and ciprofloxacin.Conclusion: According to the results, neonatal sepsis was primarily caused by CONS and Acinetobacter spp. as they showed high resistance to first- and second-generation antibiotics at the NICU. Therefore, it is recommended that proper policies be adopted to restrict antibiotic use without prescription in the community.