A Survey of the Prevalence Rate and Antibiotic Resistance Pattern of Microbial Agents in Preterm Neonatal Sepsis

Abstract

Background: Sepsis is one of the most dangerous neonatal infections. Bacterial causes of neonatal septicemia are different. Objectives: This study aimed to investigate the prevalence and antibiotic resistance pattern of microbial agents causing preterm neonatal sepsis. Methods: This descriptive study was performed on 1000 infants admitted to neonatal intensive care units 1 and 2 and the neonatal ward of Al-Zahra Medical Center in Tabriz, Iran, from March 2019 to June 2020. Sampling was completed through the convenience sampling method. Data were collected using a researcher-made questionnaire after evaluating its validity and reliability. The questionnaire included personal information of neonates, causes of infection, antibiotic use, hospitalization time, and medication resistance pattern. Antibiotic susceptibility testing was performed by disk diffusion technique according to the Clinical and Laboratory Standards Institute guidelines. SPSS software version 22 was used for data analysis. Results: Among all studied neonates, 78 cases (7.8%) had positive blood cultures. The most common cause of neonatal infection was preterm birth (80.8%), and the most common bacterial causes of sepsis were coagulase-negative Staphylococcus (46.15) and Klebsiella pneumonia (28.2%). The highest antibiotic susceptibility of Gram-positive (coagulase-negative Staphylococcus) and Gram-negative bacteria was to ceftriaxone (47.3%) and piperacillin/tazobactam (100%), respectively, and the highest antibiotic resistance was to ampicillin and gentamicin (nearly 100%). Conclusions: Resistance to antibiotics used to treat sepsis has increased, which will cause irreparable problems in the treatment of preterm neonates if not addressed. Due to different microbial agents and drug resistance patterns in distinct regions, annual surveys should be conducted to determine drug resistance patterns, emphasizing preventive measures.