Microbial pathogens causative of neonatal sepsis in Arabic countries

Neonatal sepsis is a major cause of morbidity and mortality worldwide. We analyzed the spectrum of pathogens causing neonatal sepsis in various Arabic countries.

We analyzed hospital-based published studies on neonatal sepsis in eight Arabic countries documenting etiological pathogens and onset of sepsis published between 1990 and 2009.

Twelve studies from eight Arabic countries including 2308 newborns with culture proven sepsis and clinical signs of sepsis reported that early onset sepsis ranged from 24 to 74%. Gram-negative organisms were the predominant pathogens in Libya, Egypt, Jordan, and Iraq (65-90% of all sepsis cases) with Klebsiella species (spp.), Serratia spp., Enterobacter spp., Escherichia coli, and Pseudomonas spp. being the most frequent bacteria. In Saudi Arabia, Bahrain and Kuwait, the Gram-positive microorganisms, coagulase negative Staphylocooci and Staphylococcus aureus were taking the lead (64-75%). Group B Streptococci were the predominant pathogen (24%) in the United Arab of Emirates (UAE). Candida species were emerging in Egypt, UAE, Bahrain, and Kuwait.

The spectrum of microorganisms responsible for neonatal sepsis varies considerably in different Arabic countries. The predominance of Gram-negative bacteria as well as the emergence of Candida species in some areas asks for neonatal networks, benchmarking instruments, and surveillance programs of microorganisms.