Neonatal sepsis: an etiological study.
OBJECTIVE: A periodic review of neonatal sepsis to asses any change in the infecting organism. METHOD: A prospective study was conducted at HMC and ASH, Karachi. The babies suspected to have or developed sepsis any time during hospitalization were investigated to establish the diagnosis and isolate the causative organism. Blood culture was taken at the time of admission or when sepsis was suspected. RESULTS: Out of 109 episodes of blood culture proven sepsis 68 presented as early onset (within 48 hours of birth) and 41 as late onset sepsis (after 48 hours of birth). In early onset group Gram -ve and Gram +ve organisms were almost equal, i.e. 33 and 35 respectively. Among the gram -ve organism most of the cases were due to Klebsiella sp, and Enterococcus was the commonest Gram +ve organism. In late onset group majority of infections were due to gram +ve organisms, i.e. 30 out of 41. Staph. aureus and Staph. epidermidis were commonest. The organisms were least sensitive to Ampicillin (< 20%) and highly sensitive to Amikacin (90% to 100%), Cefotaxime was also seen as a good choice of antibiotic with sensitivity of (84%-89%). CONCLUSION: Gram +ve organisms were the main cause of neonatal sepsis. Klebsiella sp. is still the commonest organism causing early onset sepsis. The data must be periodically reviewed and antibiotic policy revised accordingly.