Clinical manifestation and laboratory findings in positive blood culture in neonatal septicemia

Neonatal septicemia is a major cause of mortality and morbidity in newborns. This study aimed to evaluate the clinical manifestation and laboratory findings of positive blood culture in neonatal septicemia. In this retrospective study, we investigated 100 positive blood culture records of neonates suffering from septicemia. A questionnaire was completed for each patient regarding their age at admission, gender, birth weight, admission time, type of delivery, pre-term or post-term delivery and the clinical symptoms. Types of organism causing sepsis and their resistance to antibiotics were evaluated and empirical treatment was the method of choice. Respiratory distress, cyanosis and lethargy were more prevalent among the patients. The antibiogram was indicative of Ampicillin resistance in 86% and Gentamicin resistance in 66% of the studied records. Moreover, it was observed that 36% of the positive blood culture cases had gram-negative and 64% had gram-positive bacteria. The most frequent bacteria in blood cultures were coagulase-negative Staphylococcus (35%), Staphylococcus Aureus (24%) and Klebsiella (18%), respectively. Other prevalent bacteria were Enterobacter, E. coli and Enterococcus (5%), Acinetobacter (3%), Pseudomonas aeruginosa and gram-negative Bacilli (2%) and Serratia (1%). According to the antibiogram, the most effective antibiotics against bacterial growth were Vancomycin, Cephalosporin, Amikacin, Co-trimoxazole and Gentamicin. Since the most frequent bacteria in neonatal septicemia cases were coagulase-negative Staphylococcus, Staphylococcus Aureus and Klebsiella, pediatricians need to select regiments able to cover the gram-negative bacteria for empirical antibiotic treatment.