Bacteriological profile and antibiotic susceptibility of early-onset neonatal bacterial infection in a neonatal unit in Cameroon

Abstract

BACKGROUND: Neonatal infection is a major public health problem, especially in developing countries. According to the World Health Organisation, about 2.3 million newborns die every year, with infection being the main cause. This remain a major concern for clinicians due to the emergence of antibiotic resistance. OBJECTIVES: The aim of this study was to assess the bacteriological profile and antibiotic susceptibility of Early-onset neonatal bacterial infections at the Douala Gynaecological-Obstetric and Paediatric Hospital (DGOPH). METHODS: This was an 18-month descriptive cross-sectional study. We included newborns aged 0 to 3 days who were admitted from 1st January 2020 to 31st January 2024 of the neonatology department of the DGOPH. Bacterial strains were identified using the Enterotube system and the antibiogram was performed using the disc diffusion method. Data analysis was performed using SPSS software and Pearson's Chi-squared test was used to assess the level of difference between proportions. RESULTS: During the study period 1520 neonates were admitted in the neonatal unit, 761 were suspected of having an early neonatal infection. On the suspected cases, 179 had a positive bacteriological culture, giving a hospital prevalence of confirmed early neonatal infection of 23.5%. Gram-negative bacilli were the most common isolates (97.2%): Escherichia coli (22.7%), Burkholderia cepacia (18.8%) and Klebsiella pneumoniae (7.7%). Fluoroquinolones and penems were the classes of antibiotics that showed in vitro susceptibility: ciprofloxacin (85.4%), ofloxacin (88.7%), levofloxacin (91.1%) and meropenem (87.8%). The main bacterial agents showed 66.7% resistance to cefotaxime. Mortality was high, with 5.5% of deaths related to confirmed early neonatal bacterial infection. CONCLUSION: This study shown a high prevalence of early neonatal infection with a variability of the local ecology. Also there was a high resistance of bacterial pathogens to the common antibiotics. All these findings were associated with a high mortality which is suggesting that a timely identification and initiation of effective antibiotherapy is necessary to reduce morbidity and mortality associated with neonatal infection.