Background: In Western countries, one of the leading causes of neonatal sepsis is Group B Streptococcus check for this species in other resources (GBS), which appears to be different from resource-limited countries, where gram negative bacilli (GNB) are reported to be more common. The aim of this study is to describe the bacterial causes of neonatal sepsis in the largest tertiary referral hospital in Rwanda.
Methods: A retrospective review was done of neonates admitted for neonatal sepsis from 1st January 2013-31st December 2013. Data collected included demographics, risk factors for sepsis, microbiologic culture results, and clinical outcomes.
Results: There were 128 neonates with positive bacterial cultures. Klebsiella check for this species in other resources spp. were the most frequent bacteria isolated (37%, 47/128), followed by Coagulase-negative Staphylococcus (29.7%, 38/128). No gram positive cocci were susceptible to ampicillin and only 18% were susceptible to oxacillin. No GNB were susceptible to ampicillin, and only 11% and 13% were susceptible to cefotaxime and gentamicin, respectively. Birth at a district hospital was associated with infection with methicillin-resistant Staphylococcus aureus check for this species in other resources (P=0.02) and multidrug resistant GNB (P=0.045). Twenty-five percent of neonates died.
Conclusions: Empiric treatment of neonatal sepsis with ampicillin combined with gentamicin or cefotaxime provided poor coverage of bacterial infections in the neonatology unit of this tertiary teaching hospital in East Africa. Revised empirical antibiotic guidelines are needed to minimize the risk of death due to neonatal sepsis in this patient population.