Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Introduction : Neonatal sepsis is a leading cause of morbidity and mortality among neonates worldwide, more so in developing countries (Schaffner et al., 2009). The correct and timely identification of infectious agents and their antibiotic sensitivity patterns are essential to guide the clinicians regarding both the empirical and definitive treatment (Thakur et al., 2016).Patients and methods: The study was performed on all neonates admitted to the neonatal intensive care unit of Damietta Specialized Hospital with suspected sepsis from August 2017 to January 2018 (46 neonates were studied). Complete blood count with total leucocytic count, platelet count, Immature to total neutrophil ratio (I/T), C-reactive protein (CRP) and cultures were done and data was reported.Results: Incidence of sepsis in our neonatal intensive care unit was 16.3%. Males were more commonly encountered. Preterm babies accounted for 67.4% of studied cases. Late onset sepsis was more common than early onset sepsis. The commonest clinical signs were lethargy, poor suckling, and respiratory distress. Blood cultures were positive in 50% of cases, the commonest isolated organism was Klebsiella (13%) followed by E-coli (10.9%) and MRSA (10.9%). Thrombocytopenia and I/T ratio>0.2 were more common with culture positive cases. Most of the bacterial isolates had low sensitivity to the commonly used empiric antibiotics. Rate of deaths among studied neonates was 19.6%.Conclusions: Determination of the neonatal sepsis incidence, risk factors, causative pathogens, and the patterns and rates of antibiotic resistance among neonates are necessary for proper management and preparation of center specific antibacterial protocols

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