Changing pattern of bacterial isolates and antimicrobial susceptbility in neonatal infections in Korle Bu Teaching Hospital, Ghana

Abstract

Most neonatal deaths in developing countries are caused by infections, birth asphyxia and prematurity. Even though most of these deaths occur at home, newborns admitted to hospital neonatal units have a high risk of contracting fatal multi-drug resistant infections. To compare the type of bacteria and the pattern of antimicrobial susceptibility of organisms causing neonatal infections in 2001/02 with 1991/92 in the same neonatal unit. We reviewed the hospital records of newborns admitted to the neonatal unit in 2001/02 that had positive blood cultures and compared the findings with similar work done 1991/92. Neonatal Unit, Korle Bu Teaching Hospital, Ghana. Gram negative organisms (predominantly Enterobacter, Klebsiella and Acinetobacter) remained the predominant cause of neonatal infection. There was a reduction in the proportion of gram negative bacteraemia [70.9% in 1991/92 vs. 54.2% in 2001/02 (p<0.001)] due to the increased prevalence of coagulase negative staphylococcus (31.9% in 2001/02 vs. 0% in 1991/92) as a cause of neonatal bacteraemia ten years later. In 1991/92 as 2001/02 all bacterial isolates showed less than 40% susceptibility to ampicillin. The susceptibility of Klebsiella and Enterobacter to commonly used aminoglycosides and cephalosporins had decreased from over 80% in 1991/92 to less than 35% in 2001/02. Bacterial causes of neonatal infections change over time and antimicrobial resistance is a major cause for concern in neonatal units in resource-poor hospitals. Improving infection control practices and instituting systems to monitor antimicrobial use and resistance will compliment community efforts to reduce neonatal mortality.