Species distribution and antimicrobial sensitivity pattern of etiologic agents in patients with neonatal sepsis, National Children’s Hospital, Ha Noi, Vietnam, 2019–2021

Abstract

Neonatal sepsis is one of the significant causes of morbidity and mortality in neonates, especially in developing countries. This study investigates the species distribution and antimicrobial susceptibility pattern of agents causing neonatal sepsis in a northern hospital in Vietnam. Materials and methods. All in-term neonates treated at the Neonatal Center, National Children’s Hospital, Vietnam between December 2019, and April 2021 who met the clinical criteria for sepsis and positive blood cultures were enrolled. Species identification and antimicrobial susceptibility testing were performed with Vitek 2 Compact (bioMerieux, France). Results. Eighty-five neonates were included with the majority of cases being early-onset sepsis (61.2%, 95% CI: 50.6–71.8%). Gram-negative, Gram-positive, and fungal isolates constituted 50.6%, 40%, and 9.4%, respectively. The most common agent was Staphylococcus aureus (28.2%) followed by Klebsiella pneumoniae and Escherichia coli (16.5% each). For those with bacteriological sepsis, Gram-negative pathogens were predominant in early-onset sepsis whereas Gram-positive pathogens were predominant in late-onset sepsis (75.0% (33/44) vs 69.7% (23/33), p 0.001). Antibiotic resistance was common among bacterial isolates, but antifungal resistance was not detected among isolates of Candida sp. Vancomycin and fluoroquinolone were very effective against Gram-positive organisms while piperacillin + tazobactam, aztreonam, and ertapenem were potent drugs against Gram-negative organisms. Conclusion. Routine investigation of microbial profiles and antimicrobial susceptibility patterns is essential to guiding strategies for the choices of empirical antimicrobials.