Bacteraemia and Antibiotic Sensitivity in Baghdad Teaching Hospital NICU

Neonatal sepsis is often lethal and results in considerable long-term morbidity among survivors if not treated adequately and expeditiously. It can be categorized into two somewhat separate syndromes based on the age of onset: early-onset and late-onset sepsis. Infants acquire harmful microorganisms that are prevalent in their surroundings, including the microbiota of their caretakers. The combination of invasive procedures frequently performed in the NICU significantly elevates the risk of sepsis in neonates.

 This study sought to ascertain the incidence of positive blood cultures and delineate the discovered organisms along with their corresponding antibiotic susceptibility patterns in the NICU of a tertiary hospital. This was a prospective descriptive research encompassing all newborns with positive sepsis cultures admitted to the NICU at Baghdad Teaching Hospital, Iraq, from January 1, 2024, to November 30, 2024.

Throughout the trial duration, a total of 980 newborns were admitted to the facility. Ninety infants with positive blood cultures were documented, yielding an incidence rate of 9.2%. Among these, 75.6% experienced early-onset sepsis, whereas 24.4% experienced late-onset sepsis. Gram-positive bacteria constituted 32.2%, but gram-negative bacteria were more prevalent at 67.8%, with Acinetobacter being the predominant species. In the 90 sepsis cases, gram-negative bacterial isolates were more prevalent in both early-onset (63.2%) and late-onset (81.8%) instances. The frequency distribution of bacterial growth types and their antibiotic resistance indicated that Acinetobacter exhibited the lowest sensitivity to antibiotics at 36.4%. The case-fatality rates were 36.4% for Acinetobacter, 17.2% for Staphylococcus spp., 66.7% for E. coli, 50.0% for Serratia marcescens, and 0.0% for Klebsiella. Acinetobacter isolates were substantially correlated with both early and late onset of sepsis, an elevated incidence of comorbidities, and increased fatality rates (P-value < 0.05).

 This study concludes that early-onset sepsis is more prevalent, with nosocomial infections, particularly gram-negative bacteria, being the predominant kind of sepsis. The majority of clinically significant organisms exhibited resistance to the primary antibiotic regimen.