Coagulase Negative Staphylococcus; the Most Common Cause of Neonatal Septicemia in Urmia, Iran

Objective: A prospective study to determine the prevalent bacterial agents of neonatal sepsis and their antimicrobial susceptibility in Imam Khomeini teaching hospital, Urmia, from Oct 2002 to Nov 2006.
Methods: Newborns with clinical signs of septicemia and positive blood culture during fifty months were prospectively studied. Samples for blood cultures, complete blood count, erythrocyte sedimentation rate, C-reactive protein, sugar, electrolytes, cerebrospinal fluid and urine analysis/culture were obtained; ampicillin and gentamycin were started empirically. Results were analyzed by SPSS13 package and cross tabulation was done.
Findings: Two thousand three hundred twenty five newborns from 4827 neonatal admissions were screened for septicemia. Two hundred twenty seven episodes of sepsis occurred in 209 newborns. The boys/girls ratio was 1.67:1 and 63.9% of patients were premature. There were 164 (72.2%) cases of EONS and 63 (27.7%) cases of LONS. Coagulase negative staphylococcus (CONS) was the most common (54%) cause of both early and late onset neonatal sepsis and showed high degree of resistance to commonly used antibiotics; ampicillin (100%), ceftriaxon (65%), cefotaxim (67%) and gentamicin (51%), but comparatively low resistance to vancomycine (10%), imipenem (19%), and ciprofloxacine (23%).
Conclusion: Neonatal sepsis in our ward is mainly caused by gram-positive organisms, which are developing resistance to commonly used antibiotics. The initial empirical choice of ampicillin and gentamycin appears to be unreasonable for our environment.

Keywords
Septicemia;Neonatal sepsis; Antibiotic sensitivity; Coagulase negative staphylococcus