Original Research Article
Year: 2021 | Month: February | Volume: 11 | Issue: 2 | Pages: 295-303
Antibiotic Resistance and Associated Factors for Neonatal Sepsis at a Selected Children’s Hospital in Zambia
Jonathan Gwasupika1,2, Patrick Kaonga1, Choolwe Jacobs1
1Department of Epidemiology & Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia
2Tropical Diseases Research Centre, Departments of clinical sciences and public health, Ndola, Zambia
3Tropical Gastroenterology and Nutrition Group, School of Medicine, University of Zambia, Lusaka, Zambia
Corresponding Author: Jonathan Gwasupika
ABSTRACT
Background: Neonatal sepsis is a common condition among neonates particularly in developing countries. Treatment of neonatal sepsis is with antibiotics, which have huge benefits when indications are clear. However, widespread utilisation of antibiotics over the years has been reported to favour the emergence of antibiotic resistance. In this study, we aimed at assessing antibiotic resistance and associated factors for neonatal sepsis at a selected children’s hospital in Zambia.
Method: We conducted a retrospective cross-sectional study from January, 2018 to December, 2019. Data was collected from files of all admitted neonates and the microbiology blood culture register. Analysis of factors associated with antibiotic resistance was done by logistic regression using STATA software, version 14 and statistical tests were done using 5% significance level and 95% confidence intervals.
Results: Out of the 172 blood cultures analysed, 61.0% (105/172) were male admitted with suspected neonatal sepsis. The median age at admission was 4 (2 - 12) days old and 69.8% (120/172) were positive blood cultures. Commonly isolated bacteria causing neonatal sepsis were Enterobacter (29.2%), E. coli (19.2%) and Staphylococcus (13.3%). Resistance of isolated bacteria towards Penicillins ranged from 80% to 100% and to third generation cephalosporins from 50% to 70% and these were the most commonly resistant antibiotics. An increase in the duration of empirical treatment was more likely (AOR= 1.12, CI: 1.01 - 1.23) to be associated with antibiotic resistance for neonatal sepsis and this finding was statistically significant.
Conclusion: Increased duration of empirical treatment in hospital was a positive predictor for antibiotic resistance. Early detection of bacteria causing sepsis and sensitive antibiotics via blood culture and drug sensitivity testing would probably reduce the rate of antibiotic resistance.
Key words: Antibiotic resistance, neonatal sepsis, Bacteria.