NEONATAL SEPSIS IN A TERTIARY CARE HOSPITAL IN SAUDI ARABIA.

Background: The frequency of neonatal sepsis cases and their causative organisms vary from one hospital to another. This study aimed to identify the incidence of neonatal sepsis, causative organisms and their antibiotics susceptibility in King Abdulaziz Medical City in Riyadh (KAMC-R) Methods: This cross-sectional study included neonates who were born in KAMC-R and had positive blood cultures during the year of 2014 within the first 90 days of life. Results: Among 85 neonates with positive blood cultures 43 (51%) had documented sepsis in their charts. Out of these 43 neonates 17 (40%) had early-onset sepsis and 26 (60%) had late-onset sepsis. Respiratory distress was found to be the most frequent presentation (79%). Overall coagulase-negative Staphylococcus (CONS) was the commonest causative organism (n=15, 35%), however in early onset sepsis Escherichia coli (E. coli) was the most prevalent organism (n=5, 29%). The antibiotics that exhibited a high degree of sensitivity among gram negative and gram positive isolates were meropenem (91.7%) and vancomycin (100%), respectively. There were 6 out of 15 Gram negative bacilli isolates (40%) that were extended spectrum beta lactamse (ESBL) producers. The infection with gram-negative organisms was more likely to be associated with poor outcome with five (33%) deaths out of 15 cases as compared to one (4%) death out of 25 gram-positive cases (p=0.02). Conclusion:The majority of neonatal sepsis cases in our hospital were caused by gram-positive bacteria, with CONS being the most isolated organism. However, gram-negative bacteria were associated with higher rates of mortality.