Methods: A retrospective review was done of neonates admitted for sepsis in 2013. Data collected included demographics, risk factors for sepsis, and microbiologic results of cultures.
Results: Files were reviewed for 128 neonates; 52% (66/128) were male; 59% (75/128) had low or extremely low birth weight; 82% (105/128) had early neonatal sepsis. Ninety-four percent (120/128) had positive blood cultures, 5% (6/128) positive urine, and 2% (2/128) positive CSF. GNB caused 54% (69/128) of infections, and Klebsiella spp. were the most frequent bacteria isolated 37% (47/128). GBS was only isolated in one case. Among Klebsiella spp., 100% were resistant to ampicillin, 86% to gentamicin, 67% to cefotaxime, and 59% to ciprofloxacin. E. coli was 100% resistant to ampicillin, gentamicin, and ciprofloxacin, and 67% resistant to cefotaxime.
Conclusion: Empiric treatment of neonatal sepsis with ampicillin and gentamicin provided poor coverage of gram negative infections (which account for over half of all positive cultures) in the neonatology unit in this tertiary teaching hospital in East Africa. The high incidence of MDR gram negative infections is concerning in a setting in which carbapenems are not readily available.