Neonatal septicemia

Objective: To determine the prevalent bacterial agents of neonatal septicem ia and their antimicrobial susceptibility in Abha Maternity Hospital, Saudi Arabia, during the years 1996-98, Methods: Any newborn with a positive blood culture during the period was pr ospectively studied. All isolates were tested for antimicrobial susceptibil ity. Results: There was a total of 1033 nursery admissions, of which 106 episode s of septicemia occurred amongst 97 neonates, The incidence of neonatal sep ticemia in the hospital was 8.6/1000 live births. The main pathogens were: Klebsiella pneumoniae (61%), Escherichia coli (10%) and Staphylococcus aure us (9%). Group B Streptococcus was isolated in only 4 infants (4%). Thirty percent of the positive growths were obtained under 24 hours, and 37% withi n 48 hours of birth, indicating intrauterine and intrapartum origin; 63% of the sepsis occurred beyond 48 hours of hospitalization thus suggesting nos ocomial acquisition. Conclusion: This study thus identifies Klebsiella pneumoniae as the leading bacterial agent of neonatal sepsis in our environment in contrast with Wes tern countries where Group B Streptococcus is predominant. Based on in vitr o susceptibility test results, a combination of gentamicin and cefotaxime i s recommended; and no more conventional use of ampicillin, for empirical tr eatment of neonatal sepsis in our hospital. Control measures for limiting n osocomial infection are suggested.