Bacteriological aspects of septicemia and antibiotherapy in Tunisian neonates

Objectives - The aim of the study was to identify the germ for neonatal sep ticemia and to propose the first-line antibiotherapy. Material and methods - A retrospective review was made of 202 cases of sept icemia with positive blood culture in neonates admitted to a neonatal inten sive care unit in Sousse (Tunisia) between 1991 and 1993. Results - Two-thirds of the isolated bacteria were gram-negative bacilli an d one-third were gram-positive cocci. The most frequent isolated bacteria i n maternofetal septicemia were Escherichia Coil (18.4%), group B Streptococ cus (14.18%), and Klebsiella (11.3%). In postnatal non-nosocomial infection , the isolated bacteria were Escherichia Coil (28.2%), Enterobacter (23%), Klebsiella (10%), and Proteus (10%). In nosocomial sepsis, the isolated bac teria were Klebsiella (45.45%), Pseudomonas (22.7%) and Enterobacter Sp (13 .3%). Comments - We suggest that the first-line antibiotherapy should include amp icillin with cefotaxime and amikacine for maternofetal septicemia, cefotaxi me and amikacine for postnatal non-nosocomial infection, and amikacine with an agent other than a third-generation cephalosporin (imipenem) for nosoco mial infection. (C) 1999 Editions scientifiques et medicales Elsevier SAS.