Coagulase Negative Staphylococcus; the Most Common Cause of Neonatal Septicemia in Urmia, Iran

Abstract

Objective: A prospective study to determine the prevalent bacterial agents of neonatal sepsis and their antimicrobial susceptibility in Imam Khomeini teaching hospital, Urmia, from Oct 2002 to Nov 2006. Methods: Newborns with clinical signs of septicemia and positive blood culture during fifty months were prospectively studied. Samples for blood cultures, complete blood count, erythrocyte sedimentation rate, C‐reactive protein, sugar, electrolytes, cerebrospinal fluid and urine analysis/culture were obtained; ampicillin and gentamycin were started empirically. Results were analyzed by SPSS13 package and cross tabulation was done. Findings: Two thousand three hundred twenty five newborns from 4827 neonatal admissions were screened for septicemia. Two hundred twenty seven episodes of sepsis occurred in 209 newborns. The boys/girls ratio was 1.67:1 and 63.9% of patients were premature. There were 164 (72.2%) cases of EONS and 63 (27.7%) cases of LONS. Coagulase negative staphylococcus (CONS) was the most common (54%) cause of both early and late onset neonatal sepsis and showed high degree of resistance to commonly used antibiotics; ampicillin (100%), ceftriaxon (65%), cefotaxim (67%) and gentamicin (51%), but comparatively low resistance to vancomycine (10%), imipenem (19%), and ciprofloxacine (23%). Conclusion: Neonatal sepsis in our ward is mainly caused by gram‐positive organisms, which are developing resistance to commonly used antibiotics. The initial empirical choice of ampicillin and gentamycin appears to be unreasonable for our environment.