MICROBIAL PROFILING, ANTIMICROBIAL & MOLECULAR CHARACTERISATION OF BACTERIAL ISOLATES CAUSING SEPSIS AMONG PRETERM NEONATES AT KITALE COUNTY HOSPITAL; KENYA

Abstract

Globally preterm births have been on the increase and sepsis has been found as a contributor to mortality and morbidity among very low birth weight (VLBW) neonates, (<1500g) in new-born units. In this descriptive cross-sectional study, we sort to determine microbial profiling, antimicrobial and molecular characterization of common bacterial isolates causing neonatal sepsis (NS) among preterm neonates in new-born unit at Kitale County Hospital (KCH), Kenya. Blood samples (181) were collected from eligible preterm neonates and cultured using established laboratory protocols. Well-structured questionnaires were used to get relevant information about the mothers and new-borns. Majority 107 (59.1%) were female while 40.9% (74) were male. Their gestational age ranged from 30 to 36 completed weeks with a mean gestational age of 34.10 ± 1.743. Majority of the isolates were Gram positive 35(85.4%) with Coagulase Negative Staphylococcus (CoNS) 31 (88.5%) being the most predominant. Among the Gram negative 6 (14.6%), Salmonella spp were the predominant 3 (50%). Gram positive isolates were susceptible against Levofloxacin, Moxifloxacin, Clindamycin and Linezolid but were 100% resistant to penicillin. Gram negative isolates tested against Amoxicillin/clavulanic acid, Piperacillin/Tazobactam, Cefuroxime, Cefepime, Aztreonam, Meropenem, Ciprofloxacin and Trimethoprim/sulfamethoxazole were observed to be susceptible. Further screening of the Gram-positive bacteria for mecA markers, six (6) turned positive. Cycle thresholds for Staphylococcus epidermidis (3) were 28.87, 34.38 and 38.43, Staphylococcus warneri and Staphylococcus hominis were 37.34 and 32.76 respectively while Enterococcus faecalis was 26.76. Gram negative bacteria were screened for blaOXA48 and bla KPC genes with four turning positive. Salmonella spp (2) had cycle threshold of 30.61 and 30.69, Escherichia coli had 33.64 while Pseudomonas aeruginosa had 35.43. Various risk factors and organisms were strongly associated with the development of neonatal sepsis at KCH new born unit. There exists Multi Drug Resistance (MDR) genes in bacteria circulating in new-born unit of Kitale County Hospital. Policies for management and treatment of mothers and their neonates at risk of developing septicaemia should be utilized by health care providers at KCH.