Page 1 of 5 Microbiology of Neonatal Gram-Negative Sepsis in A Level III Neonatal Intensive Care Unit (NICU). A Single Center Experience Mustafa AlAbdullatif 1 *, Hassib Narchi 2 , Nusrat Khan 1 , Aiman Rahmani 1 , Tasnim Alkhatib 1 , Omar Abu- Sa’da 1 and Mohammad Khassawneh 1 1 Tawam Hospital, Neonatology division, United Arab Emirates 2 College of Medicine and Health Sciences, United Arab Emirates Introduction Sepsis, especially when caused by Gram-negative organisms, is a leading cause of neonatal mortality. The prevalence of neonatal Gram-negative sepsis varies among institutions and may be as high as 78% [1-4]. It is often associated with a poor neonatal outcome [5]. The causative organisms and their susceptibility to antibiotics are continuously changing over time and from one neonatal unit to another. The emergence of multidrug resistance (MDR) among these organisms is a major challenge to the medical team. The epidemiology of resistance in Gram-negative bacteria (GNB) can vary considerably by geographical locations. In a recent global surveillance report by the World Health Organization (WHO), in the Eastern Mediterranean Region, carbapenem resistance rates in Klebsiella species varied from zero to fifty four percent. Resistance to third generation cephalosporins was reported in 17-50% of isolated organisms 6. National data from the United Arab Emirates (UAE) - Abu Dhabi 2012, revealed that E.coli and Klebsiella pneumoniae resistance to third generation cephalosporins were (22% and 17% respectively), with a 1.5% carbapenem resistance rate [6]. Standard medical care recommends the immediate administration of empiric antibiotic therapy as soon as sepsis is suspected, ideally within one hour [7], in addition to resuscitation and stabilization. The initial choice of antibiotics is based on the likely pathogens, and the antibiotic susceptibility patterns of organisms in a NICU or data in the region. Empiric therapy for sepsis that can be caused by MDR organisms may lead to unnecessary over *Corresponding author: Mustafa AlAbdullatif, Neonatology fellow, Department of Pediatrics, Tawam Hospital, Al Ain, United Arab Emirates. Received Date: September 11, 2019 Published Date: September 17, 2019 Research Article Copyright © All rights are reserved by Mustafa AlAbdullatif This work is licensed under Creative Commons Attribution 4.0 License GJPNC.MS.ID.000519. ISSN: 2689-422X DOI: 10.33552/GJPNC.2019.01.000519 Global Journal of Pediatrics & Neonatal Care Abstract Background: Sepsis is still a leading cause of neonatal morbidity and mortality especially when caused by Gram-negative bacteria. The causative organisms and their susceptibility to antibiotics vary among units. Empiric antibiotic therapy is based on the likely pathogens and their susceptibility pattern in a NICU. This study aims to identify, in a cohort of neonates diagnosed with Gram-negative sepsis, the bacteriological profile and the antibiotic susceptibilities as well as to evaluate the appropriateness of the empirical antibiotic coverage. Material and methods: In this retrospective observational study, all Gram-negative pathogens isolated in the blood culture of neonates admitted to the neonatal unit in a tertiary referral hospital between January 2011and December 2015 were analyzed. Demographic data, causative organisms, antibiotic susceptibility, empiric therapy and outcomes were collected and analyzed. Results: Of the 2732 neonates admitted to NICU, 80 infants (2.9%) had a blood culture-proven sepsis with a Gram-negative pathogen. Klebsiella pneumonia was the commonest causative organism. Sensitivity to gentamicin and meropenem were 95% and 99% respectively. Mortality, necrotizing enterocolitis, periventricular leukomalacia, bronchopulmonary dysplasia, intraventricular hemorrhage, retinopathy of prematurity was more prevalent in affected infants. Conclusion: In our unit, neonatal sepsis caused by gram-negative organisms was highly sensitive to aminoglycosides. Almost all cases Gram- negative sepsis were adequately covered by carbapenem. Key words: Antibiotics resistance; Bacteriological profile; Gram negative; Neonatal sepsis