Background: Neonatal sepsis is one of the leading causes of mortality in the neonatal intensive care unit (NICU) of most developing countries. Antibiotic resistance is rapidly becoming a challenge in the NICU, particularly in developing countries like Nigeria. Knowledge of the bacteriological agents and their antimicrobial susceptibility pattern is essential to successfully manage sepsis in the NICU. This study was designed to determine the bacteriological etiology and antibiotic susceptibility pattern of isolates obtained from cases of neonatal sepsis in the NICU of our hospital. Methods: This was a retrospective analytical study of all blood culture-positive cases of neonatal sepsis in the NICU of Lagos State University Teaching Hospital (LASUTH), Lagos, Nigeria between April 2020 and May 2021. All neonates with a positive blood culture were identified. Patient demographics, clinical details, and laboratory data including bacteriological profiles and antimicrobial susceptibilities were recorded and analyzed using SPSS version 20. Results: One hundred and seventy-four neonates with sepsis were investigated. Of these, 56 (32%) were blood culture-positive. A total of 44 (78.6%) out of 56 infected neonates had early-onset sepsis. Of the 56 clinically relevant blood isolates, 47 (84%) were Gram-positive bacteria, 25 (44.6%) of which were Staphylococcus aureus. The percentages of the S. aureus isolate resistant to commonly used antibiotics were: 36%, 48%, 52%, 0% and 15% against cefotaxime, ciprofloxacin, gentamicin, linezolid and meropenem, respectively. The most common Gram-negative bacterial isolate was Klebsiella pneumoniae representing 7.1%. All the K. pneumoniae isolates were resistant to cefotaxime, ceftazidime, ciprofloxacin and gentamicin but fully susceptibility to meropenem (100%) and moderately to amikacin (66%). Conclusion: About a third of the neonates in our NICU were septic during the period of investigation. S. aureus was the most common cause of neonatal sepsis in our study. A high number of the bacterial isolates were multidrug-resistant, a finding that poses serious treatment challenges in this unit. It is recommended that the choice of antibiotic therapy must be informed by the results of susceptibility testing and the institution of periodic surveillance programs.
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