title: Early-onset sepsis in a neonatal intensive care unit in Beni Suef, Egypt: bacterial isolates and antibiotic resistance pattern.
abstract: OBJECTIVE
  To identify the frequency of bacterial isolates in early-onset neonatal sepsis (EONS) and their antimicrobial resistance pattern.
  
  
  METHODS
  A retrospective study of EONS was conducted at the Beni Suef University Hospital from September 2008 to September 2012. A case of EONS was defined as an infant who had clinical signs of infection or who was born to a mother with risk factors for infection, and in whom blood culture obtained within 72 hours of life grew a bacterial pathogen.
  
  
  RESULTS
  Of 673 neonates screened, there were 138 positive blood cultures (20.5%) (confirmed EONS). Of the recovered isolates, 86.2% were gram-negative pathogens. Klebsiella pneumoniae (42.8%), Enterobacter cloacae (22.5%), and Escherichia coli (13.8%) were the commonest isolated organisms. The most common gram-positive microorganism was Staphylococcus aureus accounting for only 12 isolates (8.7%). All Klebsiella isolates and 93% of Enterobacter isolates were resistant to ampicillin. Gram-negative pathogens had the maximum overall sensitivity to imipenem, cefepime, and ciprofloxacin; whereas, gram-positive isolates were most susceptible to vancomycin, imipenem, and piperacillin.
  
  
  CONCLUSIONS
  K. pneumoniae was the predominant causative bacteria of EONS followed by E. cloacae and E. coli. There was a high resistance to ampicillin. Imipenem had the maximum overall activity against the causative bacteria. Continuous surveillance is needed to monitor the changing epidemiology of pathogens and antibiotic sensitivity.
authors.affiliation: Department of Pediatrics, Beni Suef University Faculty of Medicine, Beni Suef, Egypt.
authors.forename: Sameh Samir
authors.initials: SS
authors.lastname: Fahmey
keywords: Drug Resistance; Newborn; Sepsis
references.citation: Arch Dis Child Fetal Neonatal Ed. 2003 Mar;88(2):F89-93
references.pmid: 12598493
references.citation: J Hosp Infect. 1996 Nov;34(3):211-6
references.pmid: 8923276
references.citation: Arch Dis Child Fetal Neonatal Ed. 2006 Jan;91(1):F72-4
references.pmid: 16371394
references.citation: Indian J Med Microbiol. 2009 Jul-Sep;27(3):279
references.pmid: 19584521
references.citation: Obstet Gynecol. 2010 Dec;116(6):1381-1386
references.pmid: 21099606
references.citation: J Pak Med Assoc. 2002 Aug;52(8):348-50
references.pmid: 12481673
references.citation: Arch Dis Child Fetal Neonatal Ed. 2005 May;90(3):F220-4
references.pmid: 15846011
references.citation: J Glob Infect Dis. 2013 Jan;5(1):3-7
references.pmid: 23599610
references.citation: Paediatr Perinat Epidemiol. 2010 Sep;24(5):479-87
references.pmid: 20670228
references.citation: J Perinatol. 2011 Dec;31(12):794-8
references.pmid: 21527901
references.citation: Ital J Pediatr. 2011 Jul 11;37:32
references.pmid: 21745376
references.citation: Indian Pediatr. 2005 Jan;42(1):9-13
references.pmid: 15695852
references.citation: Infect Control Hosp Epidemiol. 2001 Dec;22(12):767-70
references.pmid: 11876455
references.citation: Int J Infect Dis. 2009 Jul;13(4):499-505
references.pmid: 19058989
references.citation: Infect Control Hosp Epidemiol. 1999 Apr;20(4):242-6
references.pmid: 10219874
references.citation: J Perinat Med. 2006;34(2):166-72
references.pmid: 16519624
references.citation: Pediatr Infect Dis J. 2009 Jan;28(1 Suppl):S19-21
references.pmid: 19106758
references.citation: J Pediatr. 1979 Jul;95(1):89-98
references.pmid: 480023
references.citation: Eur J Pediatr. 2012 Jun;171(6):901-9
references.pmid: 22215129
references.citation: Arch Dis Child Fetal Neonatal Ed. 2000 Jan;82(1):F1-2
references.pmid: 10634830
references.citation: Pediatr Neonatol. 2012 Aug;53(4):245-51
references.pmid: 22964282
references.citation: Int J Infect Dis. 2011 Sep;15(9):e631-4
references.pmid: 21715207
references.citation: Arch Pediatr Adolesc Med. 1998 Jan;152(1):35-40
references.pmid: 9452705
references.citation: J Paediatr Child Health. 2012 Jul;48(7):604-9
references.pmid: 22404730