Pattern of Microbial Infections during the First 72 Hours of Neonate Life at Khafji General Hospital Neonatal Intensive Care Unit


  • Northern Border University, Department of Pharmaceutics, Faculty of Pharmacy, Arar, Saudi Arabia
  • AlKhafji General Hospital, Khafji, 39256, Saudi Arabia


Neonatal infection is an important cause of morbidity and mortality of neonates. The objective of this study is to evaluate the pattern of microbial infections during the first 72 hours of neonate life at AlKhafji General Hospital Neonatal Intensive Care Unit. This is a hospital-based retrospective study design in AlKhafji General Hospital (KGH) in Khafji City, Saudi Arabia. The data was collected from sensitivity reports and results of isolated cultures of random sample of 74 infected neonates admitted to NICU. Data was analyzed by SPSS program by descriptive statistics. Among the 74 significant culture positive cases, there were 54% male and 46% female neonates. The most common microorganism isolated from neonates in NICU was Pseudomonas aeruginosa (13.5%) followed by E. coli and Enterobacter (12.1%) and (9.5%) respectively. 18.9% of the isolated bacteria were sensitive to vancomycin including Staphylococcus aureus, Staphylococcus hominis, Enterobacter, MRSA, Enterococi, C. diff and Listeria monocytogenes. 12.2% of the isolated bacteria were sensitive to ampilcillin including Staphylococcus aureus, Acinetobacter, Enterobacter, Strep. pyogenses, Enterococi and Anaerobes. 10.8% of the isolates were sensitive to imipenem including Phenomena paucimobilis, Staphylococcus hominis, E. coli, Enterobacter, Staphylococcus sciuri and Pseudomonas aeruginosa. Gram negative bacteria specifically Pseudomonas aeruginosa and E. coli are the most common causes of infection of neonates in NICU. Pathogens causing neonatal infections exhibit varying antibiotic sensitivity pattern. However, the most sensitivity recorded was for vancomycin. Additionally, the emerging multi drug resistant microorganism such as Acinetobacter in NICUs could be a health risk in future.


Intensive Care Unit, Microbial Infections, Neonatal, Treatment

Subject Discipline


Full Text:


Vergnano S, Menson E, Kennea N, Embleton N, Russell AB, Watts T, et al. Neonatal infections in England: The Neon IN surveillance network. Archives of Disease in Childhood-fetal and Neonatal Edition. 2011; 96(1):F9–F14. PMid:20876594.

Gosalia E, Mistry M, Goswami Y, Gosalia V, Vasa P. A bacteriological profile of neonatal septicemia (Study in Tertiary Care Hospital, Rajkot). International Journal of Contemporary Pediatrics. 2013; 4(2):44–7.

Meem M, Modak JK, Mortuza R, Morshed M, Islam MS, Saha SK. Biomarkers for diagnosis of neonatal infections: A systematic analysis of their potential as a point-of-care diagnostics. Journal of Global Health. 2011; 1(2):201.

Shrestha S, Shrestha N, Singh SD, Shrestha R, Kayestha S, Shrestha M, et al. Bacterial isolates and its antibiotic susceptibility pattern in NICU. Kathmandu University Medical Journal. 2014; 11(1):66–70. PMid: 23774417.

Bas AY, Demirel N, Zenciroglu A, Gol N, Tanir G. Nosocomial blood stream infections in a neonatal intensive care unit in Ankara, Turkey. Turk J Pediatr. 2010; 52(5):464–70.

Sharma CM, Agrawal RP, Sharan H, Kumar B, Sharma D, Bhatia SS. Neonatal Sepsis: Bacteria and their susceptibility pattern towards antibiotics in Neonatal Intensive Care Unit. Journal of Clinical and Diagnostic Research: JCDR. 2013; 7(11):2511. PMid: 24392386 PMCid: PMC3879858.

Monsef A, Eghbalian F. Antibiotic sensitivity pattern of common bacterial pathogens in NICU and neonatal ward in Hamedan province of Iran. Health. 2010; 2(06):625.

Mohammadi P, Kalantar E, Bahmani N, Fatemi A, Naseri N, Ghotbi N, et al. Neonatal bacteriemia isolates and their antibiotic resistance pattern in Neonatal Insensitive Care Unit (NICU) at Beasat Hospital, Sanandaj, Iran. Acta MedicaIranica. 2014; 52(5):337–40.

Boskabadi H, Maamouri G, Afshari JT, Mafinejad S, Hosseini G, Mostafavi Toroghi H, et al. Evaluation of serum interleukins-6, 8 and 10 levels as diagnostic markers of neonatal infection and possibility of mortality. Iranian Journal of Basic Medical Sciences 2013; 16(12):1232.

Yalaz M, Çetin H, Akisu M, Aydemir S. Neonatal nosocomial sepsis in a level-III NICU: Evaluation of the causative agents and antimicrobial susceptibilities. The Turkish Journal of Pediatrics. 2006; 48(1):13.

Darvishpour A, Hashemian H, Faal E, Fasihi M. Survey of nosocomial infection and accompanied factors in Neonatal Intensive Care Unit. Journal of Guilan University of Medical Sciences. 2010; 19(73):37–45.

12. Apostolopoulou E. Nosocomial bloodstream infections in neonatal intensive care unit: Excess of length of stay, extra costs of antibiotics. ICUs Nurs Web J. 2004; 19:1–7.

Larypoor M, Frsad S. Evaluation of nosocomial infections in one of hospitals of Qom. 2008. Iranian Journal of Medical Microbiology. 2011; 5(3):7–17.

Burke JP. Infection control - a problem for patient safety. New England Journal of Medicine 2003; 348(7):651–6. PMid: 12584377.

Kliegman R, Behrman RE, Nelson WE. Nelson textbook of pediatrics. Elsevier; 2016.

Wilson CB, Nizet V, Maldonado Y, Klein JO, Remington JS. Remington and Klein’s infectious diseases of the fetus and newborn infant: Elsevier Health Sciences; 2015.

Kawagoe JY, Segre CA, Pereira CR, Cardoso MFS, Silva CV, Fukushima JT. Risk factors for nosocomial infections in critically ill newborns: A 5-year prospective cohort study. American Journal of Infection Control. 2001; 29(2):109–14. PMid: 11287879.

Eltaib L, Alanazi SA, Ali SE. Practices and attitudes concerning expiration date, unused and expired medication disposal. Int J Med Sci Public Health. 2020; 9(7):431–8.

Report of the National Neonatal Perinatal Database (National Neonatology Forum). 2002-03.

Boskabad H, Moudi A, Parvini Z, Barati T. Evaluation of the cause and related factors of neonatal mortality in Qaem hospital 1388-89. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2012; 14(7):21–6.

Taeusch HW, Ballard RA, Gleason CA, Avery ME. Avery’s diseases of the newborn: Elsevier Health Sciences; 2005. Lina Eltaib, Bashaer W. Alenzi, Parents Knowledge, Attitude and Practices regarding children vaccination in Northern Border Area (Saudi Arabia): Cross Sectional Study, Indo Am. J.P. Sci. 2020; 07(09).

Brightman VJ, Scott TF, Westphal M, Boggs TR. An outbreak of coxsackie B-5 virus infection in a newborn nursery. J Pediatr. 1966; 69:179–92.

Boskabadi H, Maamouri G, Mafinejad S. Neonatal complications related with prolonged rupture of membranes. Macedonian Journal of Medical Sciences. 2011; 4(1):93–8.

Romero R, Chaiworapongsa T, Espinoza J. Micronutrients and intrauterine infection, preterm birth and the fetal inflammatory response syndrome. The Journal of Nutrition. 2003; 133(5):1668S–73S. PMid: 12730483.

Sundaram V, Kumar P, Dutta S, et al. Blood culture confirmed bacterial sepsis in neonates in a North Indian tertiary care center: Changes over the last decade. Jpn J Infect Dis. 2009: 62;46–50.

Patel, Sameer J, et al. Gram-negative Bacilli in infants hospitalized in the Neonatal Intensive Care Unit. Journal of the Pediatric Infectious Diseases Society. 2017; 6(3):227–30. PMid: 27302327 PMCid: PMC5907873. doi:10.1093/jpids/ piw032

Harris J, Goldmann D. Infections acquired in the nursery: Epidemiology and control. Remington JS, Klein JO, eds. Infectious diseases of the fetus, newborn and infants, 5th ed. Philadelphia: WB Saunders; 2001. p. 1371–418.

Klein JO. Bacterial sepsis and meningitis. Remington JS, Klein JO, eds. Infectious diseases of the fetus, newborn and infants, 5th ed. Philadelphia: WB Saunders; 2001. p. 943–84.

Eltaib L, Mujtaba MA, Amir D, Rikabi H. Evaluation of community pharmacist dispensing and counseling practice. International Journal of Biology, Pharmacy and Allied Sciences. 2019. IJBPAS/2019/8.6.4745

Korpela JK, Campbell J, Singh N. Health care associated infections. Mhairi MG, Mullett MD, Seshia MM, ed. Avery’s Neonatology: Pathophysiology and Management of the Newborn. Philadelphia: Lippincott Williams Wilkins; 2005. p. 1356–83.

Roy A, Jain M, Kumar M, Agarwal SK. Bacteriology of neonatal septicemia in a tertiary care hospital of northern India. Indian J Med Microbiol. 2002; 20:156–9.

Desai KJ, Malek S. Neonatal Septicemia: Bacterial isolates and their antibiotics susceptibility patterns. National Journal of Integrated Research in Medicine. 2010; 1:12–5.

Schreiber JR, Berger M. Intravenous immune globulin therapy for sepsis in premature neonates. J Pediatr. 1992; 121:401–4.

Jain A, Roy I, Gupta M, Kumar M, Agarwal SK. Prevalence of extended-spectrum β-lactamase-producing Gramnegative bacteria in septicaemic neonates in a tertiary care hospital. J Medical Microbiol. 2003; 52:421–5. PMid: 12721319.

Narang A, Rao R, Bhakoo ON. Neonatal necrotizing enterocolitis: A clinical study. Indian Pediatr. 1993; 30:1417–22.

Bhutta ZA, Naqvi SH, Muzaffar T. Neonatal sepsis in Pakistan. Acta Paediatr Scand. 1991; 80:596–601. PMid: 1867074.

Khan IA, Akram DS. Neonatal sepsis - etiological study. J Pak Med Assoc. 1987; 37:327–30.

Ako-Nai AK, Adejuyigbe EA, Ajayi FM, Onipede AO. The bacteriology of neonatal septicaemia in lle-Ife, Nigeria. J Trop Pediatr. 1999; 45:146–51. PMid: 10401192. https://

Kaushik SL, Parmar VR, Grover N, Grover PS, Kaushik R. Neonatal sepsis in hospital born babies. J Commun Dis. 1998; 30:147–52.

Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, et al. Late-onset sepsis in very low birth weight neonates: The experience of the NICHD Neonatal Research Network. Pediatrics. 2002; 110(2Pt1):285–91. PMid: 12165580.

Fridkin SK, Kaufman D, Edwards JR, Shetty S, Horan T. Changing incidence of Candida bloodstream infections among NICU patients in the United States: 1995-2004. Pediatrics. 2006; 117(5):1680–7. PMid: 16651324. https://

Manzoni P, Farina D, Leonessa M, d’Oulx EA, Galletto P, Mostert M, et al. Risk factors for progression to invasive fungal infection in preterm neonates with fungal colonization. Pediatrics. 2006; 118(6):2359–64. PMid: 17142519.

Mahieu LM, Van Gasse N, Wildemeersch D, Jansens H, Ieven M. Number of sites of perinatal Candida colonization and neutropenia are associated with nosocomial candidemia in the neonatal intensive care unit patient. Pediatr Crit Care Med. 2010; 11(2):240–5. PMid: 19794324.

Mendiratta DK, Rawat V, Thamke D, Chaturvedi P, Chhabra S, Narang P. Candida colonization in preterm babies admitted to neonatal intensive care unit in the rural setting. Indian J Med Microbiol. 2006; 24(4):263–7. PMid: 17185844.

Farmaki E, Evdoridou J, Pouliou T, Bibashi E, Panagopoulou P, Filioti J, et al. Fungal colonization in the neonatal intensive care unit: Risk factors, drug susceptibility and association with invasive fungal infections. Am J Perinatol. 2007; 24(2):127–35. PMid: 17304423.


  • There are currently no refbacks.