Педиатрия и терапия
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Neonatal Gram-negative Sepsis in a Tertiary Hospital in Jordan: When Fever Means Multidrug Resistance!

Manar Al-lawama*,Eman Badran,Najwa Khuri-Bulos

Objective: Development of multidrug resistance in Gram-negative bacteria affecting neonates is a major challenge. Studying the epidemiology and clinical presentation is crucial to improve preventive and therapeutic measures and helps to decrease morbidity and mortality. This study is the first to report Carbapenems resistant gram negative bacteria in neonates in the Arab world. It will stimulate further research efforts and increase awareness of health decision makers towards this potentially lethal pathogen. Methodology: This retrospective hospital-based study investigated neonatal sepsis caused by Gram-negative bacteria and identified three groups of microorganisms: Cephalosporin sensitive, Cephalosporin resistant and Carbapenems resistant bacteria (CRB). Clinical presentation, risk factors and outcome were compared. Results: Gram-negative bacteria isolated from 99 blood cultures were included in the study. The most common Gram negative bacteria were Cephalosporin resistant (47 septic episodes), followed by Carbapenems resistant bacteria (28 septic episodes). Of the cases included, 70% were late septic episodes. Acinetobacter was the only Carbapenems resistant microorganism. Fever was the most common symptom in the Cephalosporin and Carbapenems resistant groups. The mortality rate was 16.2%, with the lowest mortality rate being found in the CRB group. None of the mortalities had fever at presentation. Conclusion: CRB are a major cause of neonatal sepsis in our hospital. In units where multidrug resistance is an issue, febrile neonates should be managed with great care.