Neonatal sepsis: Bacteriological profile,molecular detection and antimicrobial susceptibility test among pre-term pediatrics in Erbil city, Iraq

  • Sherko Muhammed Abdul-Rahman Department of Biology, College of Education, Salahaddin University, Erbil, Iraq
  • Adel Kamal Khider Department of Biology, College of Education, Salahaddin University, Erbil, Iraq
Keywords: Neonatal Sepsis, Early onset sepsis, Late onset sepsis, CRP, VITEK 2 system


Background and objective: Neonatal sepsis refers to infection occurring within the neonatal period, the first 28 days of life for a term baby, and up to 4 weeks beyond the expected date of delivery in a pre-term baby. This study was designed to determine the frequency of neonatal early onset sepsis and late onset sepsis in some hospitals in Erbil city.

Methods: Out of 170 neonate samples from Neonatal Intensive Care Unit in Rapareen Pediatric Teaching Hospital and Maternity Obstetric Hospital randomly were studied through isolation and identification of causative bacteria using the traditional approach, VITEK 2 compact system, molecular detection using PCR technique, moreover, C-reactive protein and white blood cell count detected as biomarker assay. The isolated bacteria tested against some widely used antibiotics.

Results: The sepsis was confirmed in 54 (31.76%) patients of total neonates with suspected cases of sepsis by clinical signs and symptoms. EOS was 42 (77.77%) were detected, and late onset sepsis was 12 (22.23%). Identification of the isolated bacteria by the traditional method, and VITEK 2 compact system were performed. In addition, molecular detection via the PCR system through the detection of the specific genes was performed. Antimicrobial Susceptibility test indicated that most of the isolated bacteria were developed resistant to the most widely used antimicrobials.

Conclusion: Our study showed a high incidence of neonatal early onset sepsis more than late onset sepsis, mostly associated with Gram-negative bacteria than Gram-positive bacteria.


Russell AR. Neonatal sepsis. Paediatr Child Health 2015; 25(6):271–5

Manzoni P, Rinaldi M, Cattani S, Pugni L, Romeo MG, Messner H, et al. Bovine lactoferrin supplementation for prevention of late-onset sepsis in very low-birth-weight neonates: a randomized trial. JAMA 2009; 302(13):1421–8.

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(2):285–91.

Alarcon A, PeÑa P, Salas S, Sancha M, OmeÑaca FJT. Neonatal early onset Escherichia coli sepsis: trends in incidence and antimicrobial resistance in the era of intrapartum antimicrobial prophylaxis. Pediatr Infect Dis J 2004; 23(4):295–9.

Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, et al. Changes in pathogens causing early-onset sepsis in very-low-birth-weight infants 2003; 58(1):17–8.

Dong Y, Speer CP. The role of Staphylococcus epidermidis in neonatal sepsis: guarding angel or pathogenic devil? International journal of medical microbiology: IJMM 2014; 304(5-6):513–20.

Marchant EA, Boyce GK, Sadarangani M, Lavoie PMJC, Immunology D. Neonatal sepsis due to coagulase-negative staphylococci. Clin Dev Immunol 2013; 2013:586076.

Lebea MM, Davies VJ. Evaluation of culture-proven neonatal sepsis at a tertiary care hospital in Johannesburg, South Africa. SAJCH 2017; 11(4):170–3.

Calfee DP, Farr BMJ. Comparison of four antiseptic preparations for skin in the prevention of contamination of percutaneously drawn blood cultures: a randomized trial. J Clin Microbiol 2002; 40(5):1660–5.

Doern CD, Mirrett S, Halstead D, Abid J, Okada P, Reller LB. Controlled Clinical Comparison of New Pediatric Medium with Adsorbent Polymeric Beads (PF Plus) versus Charcoal—containing PF Medium in the BacT/ALERT® Blood Culture System. J Clin Microbiol 2014: 52(6):1898–1900.

Pincus DH. Microbial identification using the bioMérieux Vitek 2 system. In: Miller MJ (Ed.), Encyclopedia of rapid microbiological methods 1-32. Parenteral Drug Association, Bethesda, USA; 2006.

Anbazhagan D, Kathirvalu GG, Mansor M, Yan GOS, Yusof MY, Sekaran SD. Multiplex polymerase chain reaction (PCR) assays for the detection of Enterobacteriaceae in clinical samples. African Journal of Microbiology Research 2010; 4(11):1186–91.

Chen J, Griffiths MJ. PCR differentiation of Escherichia coli from other Gram‐negative bacteria using primers derived from the nucleotide sequences flanking the gene encoding the universal stress protein. Lett Appl Microbiol 1998; 27(6):369–71.

Turton JF, Woodford N, Glover J, Yarde S, Kaufmann ME, Pitt TL. Identification of Acinetobacter baumannii by detection of the blaOXA-51-like carbapenemase gene intrinsic to this species. J Clin Microbiol 2006; 44(8):2974–6.

Karmakar A, Dua P, Ghosh C. Biochemical and molecular analysis of Staphylococcus aureus clinical isolates from hospitalized patients. Can J Infect Dis Med Microbiol 2016; 2016:9041636.

Peykov SZ, Aleksandrova VD, Dimov SG. Rapid identification of Enterococcus faecalis by species-specific primers based on the genes involved in the Entner–Doudoroff pathway. Mol Biol Rep 2012; 39(6):7025–30.

Weinstein MP, Limbago B, Patel J, Mathers A, Campeau S, Mazzulli T, et al. M100 Performance Standards for Antimicrobial Susceptibility Testing. 28th ed. CLSI supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute; 2018.

Bedford Russell AR, Kumar R. Early onset neonatal sepsis: diagnostic dilemmas and practical management. Archives of disease in childhood Fetal and neonatal edition. Arch Dis Child Fetal Neonatal Ed 2015; 100(4):F350–4.

Mohammed WFJA. Bacteriological study of Septicemia in Neonateat Baghdad pediatric hospitals. Al-Mustansiriyah Journal of Science 2012; 23(7):49–56.

Thakur S, Thakur K, Sood A, Chaudhary S. Bacteriological profile and antibiotic sensitivity pattern of neonatal septicaemia in a rural tertiary care hospital in North India. Indian J Med Microbiol 2016; 34(1):67–71.

Aletayeb SMH, Khosravi AD, Dehdashtian M, Kompani F, Aramesh MR. Identification of bacterial agents and antimicrobial susceptibility of neonatal sepsis: A 54-month study in a tertiary hospital. African Journal of Microbiology Research 2011; 5(5):528–31.

Tosson AM, Speer CP. Microbial pathogens causative of neonatal sepsis in Arabic countries. J Matern Fetal Neonatal Med 2011; 24(8):990–4.

Pierrakos C, Vincent JL. Sepsis biomarkers: a review. Critical Care 2010; 14(1):R15.

Naher B, Mannan M, Noor K, Shahidullah MJ. Role of serum procalcitonin and C-reactive protein in the diagnosis of neonatal sepsis. Bangladesh Med Res Counc Bull 2011; 37(2):40–6.

Sadiq ZM, Al-Anee AHJ. Sepsis in Neonatology Unit of Kirkuk Pediatric Hospital. Kirkuk University Journal-Scientific Studies 2010; 5(2):1–7.

Sami MN. Early onset neonatal sepsis: clinical and bacteriological study in Duhok city. Thesis. University of Duhok, College of Science; 2018.

Aarthi P, Bagyalakshmi R, Mohan K, Krishna M, Nitin M, Madhavan H, et al. First case series of emerging rickettsial neonatal sepsis identified by polymerase chain reaction-based deoxyribonucleic acid sequencing. Indian J Med Microbiol 2013; 31(4):343.

Paolucci M, Landini MP, Sambri VJ. How can the microbiologist help in diagnosing neonatal sepsis? Int J Pediatr 2012; 2012.

Köksal N, Hacimustafaoğlu M, Bağci SJ. Meropenem in neonatal severe infections due to multiresistant gram-negative bacteria. The Indian Journal of Pediatrics 2001; 68(1):15–9.

El-Din S, Rabie EM, El-Sokkary MMA, Bassiouny MR, Hassan RJ. Epidemiology of neonatal sepsis and implicated pathogens: a study from Egypt. Biomed Research International 2015; 2015:509484.

Vergnano S, Sharland M, Kazembe P, Mwansambo C, Heath PJ. Neonatal sepsis: an international perspective. Arch Dis Child Fetal Neonatal Ed 2005; 90(3):F220–FF4.

How to Cite
Abdul-Rahman, S., & Khider, A. (2020). Neonatal sepsis: Bacteriological profile,molecular detection and antimicrobial susceptibility test among pre-term pediatrics in Erbil city, Iraq. Zanco Journal of Medical Sciences (Zanco J Med Sci), 24(2), 256-273.
Original Articles