Nosocomial infection in an Egyptian neonatal intensive care unit

We examined the etiology of nosocomial infection in a neonatal intensive care unit and determined antibiotic susceptibility of the isolated organisms to detect changes in infection patterns. The study included 56 neonates who developed nosocomial infection (10.93±11.2 days) from neonatal intensive care unit, Cairo University hospital. Four samples were collected from each neonate before treatment: blood, tracheal aspirate, urine and skin swab. Blood agar, Mac Conkey, CLED agar media and Thioglycolate broth bottles were used. For rapid identification of enterobactericae family we used API for enteric and non- enteric non- fermenter organism identification. Antimicrobial susceptibility tests were done. Nosocomial infections presented as neonatal septicemia (46.4%), pneumonia (14.3%), skin infection (10.7%) and mixed infections (28.6%). Gram-negative organisms were isolated from 42 neonates (75%), while 20 neonates showed Gram-positive septicemia (35.7%). Major isolated pathogens were Klebsiella species (39.3%), staphylococcus aureus (21.4%), coagulase negative staphylococci (14.3%), Acinetobacter species (14.3%), and pseudomonas aeroginosa (7.14%). The most encountered risk factors associated with nosocomial sepsis was prematurity (adjusted OR=9.444, 95CI=1.433-62.238). The Gram negative and positive organisms showed a high degree of resistance to commonly used antibiotics: third generation cephalosporines, amoxicillin/clavulanic acid, oxacillin, ciprofloxacin, gentamycin and trimethoprim/sulphamethaxzole. Both types of organisms were sensitive to amikacin and imipenem.