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Research article
Chidiebere Donatus Ignatius Osuorah
MRC Laboratories The Gambia
Corresponding Author
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Background: Neonatal sepsis is commonly caused by bacteria in the first 28 days of life. Due to diagnostic limitations in developing settings, prompt laboratory identification of causative organisms is usually a challenge. To prevent mortality, clear knowledge of bacteria and their antibiotic sensitivity patterns are important for prompt empirical treatment.
Methods: This prospective study enrolled 339 newborns with signs and symptoms suggestive of neonatal sepsis out of 645 that were admitted into the special care unit of the University of Teaching Hospital during the study period. Socio-demographic and clinical profiles of the newborns were obtained using a questionnaire and blood culture was done from every enrolled newborn (339 newborns) using BACTEC 9050. The bacteriological profile and antibiotic sensitivity pattern of newborns with confirmed neonatal sepsis were documented.
Results: A total of 339 newborn were admitted for probable sepsis out of a total admission of 645 newborns during the study period based on clinical features and initial laboratory work-up. Forty-six of the 645 newborns (46/645) had culture proven sepsis resulting in a neonatal sepsis incidence rate of 71.3 (95%CI 50.7-91.9) per 1000 admitted newborns. Seventeen of the 46 confirmed sepsis cases were among the 1322 newborns delivered within the study facility during the study period giving an in-hospital neonatal sepsis incidence rate of 12.9 (95% CI 6.7-19.0) per 1000 live births. Amongst the 46 babies with positive blood culture, 27/46 (58.7%) had normal white cell count while the remaining 19/46 (41.3%) had abnormal results. Fifty-two (52) counts of bacteria categorized into 11 bacteria species were isolated from the 46 positive blood cultures. Enterococcus spp and streptococcus species were the commonest gram-positive while Escherichia coli and Pseudomonas luteola were the commonest gram-negative bacteria isolates. Imipenem, amoxicillin/clavulanic acid, Vancomycin, and ofloxacin had the widest coverage of bacteria isolated from newborn with sepsis.
Conclusion: Neonatal sepsis is still prevalent in our environment and compared to previous documented isolates and sensitivity pattern, the bacteria causes, and their antibiotic sensitivity patterns appears to be changing.
Keywords
neonatal sepsis, mortality, cross-sectional study, antibiotic sensitivity
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CURRENT STATUS: Under Review
Version 2
Posted 18 Jan, 2021
No community comments so far
Editorial decision: Withdrawn by author
On 08 Aug, 2021
Reviewer #3 agreed
On 02 Jun, 2021
Reviewer #2 agreed
On 26 May, 2021
Reviewer #1 agreed
On 10 Jan, 2021
Review #1 received
Received 10 Jan, 2021
Editor assigned
On 09 Jan, 2021
Reviewers invited
Invitations sent on 09 Jan, 2021
Submission checks complete
On 09 Jan, 2021
Editor invited
On 09 Jan, 2021
No comments provided
Editorial decision: Major revision
On 21 Oct, 2020
Review #3 received
Received 19 Sep, 2020
Reviewer #3 agreed
On 27 Aug, 2020
Review #2 received
Received 27 Aug, 2020
Reviewer #2 agreed
On 26 Aug, 2020
Review #1 received
Received 12 Feb, 2020
Reviewer #1 agreed
On 02 Feb, 2020
Reviewers invited
Invitations sent on 30 Jan, 2020
Editor assigned
On 22 Oct, 2019
Submission checks complete
On 21 Oct, 2019
Editor invited
On 21 Oct, 2019
First submitted
On 18 Oct, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
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This preprint is under consideration at BMC Infectious Diseases. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Chidiebere Donatus Ignatius Osuorah
MRC Laboratories The Gambia
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 2
Posted 18 Jan, 2021
No community comments so far
Editorial decision: Withdrawn by author
On 08 Aug, 2021
Reviewer #3 agreed
On 02 Jun, 2021
Reviewer #2 agreed
On 26 May, 2021
Reviewer #1 agreed
On 10 Jan, 2021
Review #1 received
Received 10 Jan, 2021
Editor assigned
On 09 Jan, 2021
Reviewers invited
Invitations sent on 09 Jan, 2021
Submission checks complete
On 09 Jan, 2021
Editor invited
On 09 Jan, 2021
No comments provided
Editorial decision: Major revision
On 21 Oct, 2020
Review #3 received
Received 19 Sep, 2020
Reviewer #3 agreed
On 27 Aug, 2020
Review #2 received
Received 27 Aug, 2020
Reviewer #2 agreed
On 26 Aug, 2020
Review #1 received
Received 12 Feb, 2020
Reviewer #1 agreed
On 02 Feb, 2020
Reviewers invited
Invitations sent on 30 Jan, 2020
Editor assigned
On 22 Oct, 2019
Submission checks complete
On 21 Oct, 2019
Editor invited
On 21 Oct, 2019
First submitted
On 18 Oct, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Neonatal sepsis is commonly caused by bacteria in the first 28 days of life. Due to diagnostic limitations in developing settings, prompt laboratory identification of causative organisms is usually a challenge. To prevent mortality, clear knowledge of bacteria and their antibiotic sensitivity patterns are important for prompt empirical treatment.
Methods: This prospective study enrolled 339 newborns with signs and symptoms suggestive of neonatal sepsis out of 645 that were admitted into the special care unit of the University of Teaching Hospital during the study period. Socio-demographic and clinical profiles of the newborns were obtained using a questionnaire and blood culture was done from every enrolled newborn (339 newborns) using BACTEC 9050. The bacteriological profile and antibiotic sensitivity pattern of newborns with confirmed neonatal sepsis were documented.
Results: A total of 339 newborn were admitted for probable sepsis out of a total admission of 645 newborns during the study period based on clinical features and initial laboratory work-up. Forty-six of the 645 newborns (46/645) had culture proven sepsis resulting in a neonatal sepsis incidence rate of 71.3 (95%CI 50.7-91.9) per 1000 admitted newborns. Seventeen of the 46 confirmed sepsis cases were among the 1322 newborns delivered within the study facility during the study period giving an in-hospital neonatal sepsis incidence rate of 12.9 (95% CI 6.7-19.0) per 1000 live births. Amongst the 46 babies with positive blood culture, 27/46 (58.7%) had normal white cell count while the remaining 19/46 (41.3%) had abnormal results. Fifty-two (52) counts of bacteria categorized into 11 bacteria species were isolated from the 46 positive blood cultures. Enterococcus spp and streptococcus species were the commonest gram-positive while Escherichia coli and Pseudomonas luteola were the commonest gram-negative bacteria isolates. Imipenem, amoxicillin/clavulanic acid, Vancomycin, and ofloxacin had the widest coverage of bacteria isolated from newborn with sepsis.
Conclusion: Neonatal sepsis is still prevalent in our environment and compared to previous documented isolates and sensitivity pattern, the bacteria causes, and their antibiotic sensitivity patterns appears to be changing.
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
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