Gestational age, birth weight, and blood culture microbial patterns in late-onset neonatal sepsis

  • Muhammad Ramadhika Faculty of Medicine, Universitas Indonesia, Jakarta
  • Stephen Diah Iskandar Faculty of Medicine, Universitas Indonesia, Jakarta
  • Ivana Yapiy Faculty of Medicine, Universitas Indonesia, Jakarta
  • Yurika Elizabeth Susanti Faculty of Medicine, Atma Jaya Catholic University of Indonesia, Jakarta
  • Marcella Amadea Wijaya Faculty of Medicine, Atma Jaya Catholic University of Indonesia, Jakarta
  • Rinawati Rohsiswatmo Department of Child Health, Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta
Keywords: Late onset neonatal sepsis, gestational age, birth weight, microbial pattern


Background The three main  causes of neonatal deaths in Indonesia according to the WHO are sepsis, prematurity, and asphyxia. A suboptimal hospital environment increases the risk of late-onset neonatal sepsis (LONS), which in turn can prolong hospital stays.

Objective To assess for possible associations  of bacterial patterns in neonates with LONS, prematurity, and/or low birth weight.

Methods Medical record data of 1,706 hospitalized neonates who were treated for sepsis or other disease in the Neonatal Unit, Dr. Cipto Mangunkusumo Hospital (CMH), Jakarta in 2020 were analyzed retrospectively. A total of 262 neonates had proven LONS. We assessed for possible risk factors such as gestational age, birth weight, and cultured blood microbes.

Results Out of a total of 1,706 neonates admitted to the neonatal unit, the incidence of proven LONS was 15.4%. LONS was more prevalent (58.4%) in preterm than in full-term (41.6%) neonates. The majority (67.6%) of subjects with proven LONS were neonates with low birth weight (LBW) (<2,500 grams), and the largest percentage of them (35.1%) was in the 1,500-2,500-gram group. Gram negative bacteria emerged as the predominant pathogens of LONS patients in our hospital; the most common were Klebsiella pneumonia, Acinetobacter spp., Escherichia coli, Enterobacter spp., and Pseudomonas aeruginosa.

Conclusion The proportion of LONS among LBW and preterm neonates is significantly higher compared to normal birth weight and  neonates. In our unit, LONS was mostly caused by Gram-negative bacteria. The antibiotic susceptibility of the various pathogens causing LONS in CMH should be tested and compared to the current empirical antibiotic guidelines used in CMH.


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How to Cite
Ramadhika M, Iskandar S, Yapiy I, Susanti Y, Wijaya M, Rohsiswatmo R. Gestational age, birth weight, and blood culture microbial patterns in late-onset neonatal sepsis. PI [Internet]. 26Feb.2024 [cited 18Apr.2024];64(1):51-. Available from:
Received 2022-12-08
Accepted 2024-02-26
Published 2024-02-26