Neonatal sepsis in a tertiary care hospital in Delhi, India: study of microbial profile and antimicrobial susceptibility pattern


  • Sangita Gupta Department of Microbiology, ESIC PGIMSR, Basaidarpur, New Delhi, Delhi, India
  • Varun Kumar Singh Department of Paediatrics, ESIC PGIMSR, Basaidarpur, New Delhi, Delhi, India
  • Sanjay Singhal Department of Microbiology, ESIC PGIMSR, Basaidarpur, New Delhi, Delhi, India
  • Priti Chowdhary Department of Microbiology, ESIC PGIMSR, Basaidarpur, New Delhi, Delhi, India



Antibiotic susceptibility, CONS, Candida, Klebsiella pneumoniae, Neonatal sepsis


Background: Sepsis is one of the most common cause of neonatal deaths globally more so in low and middle-income countries. The key to management is high degree of clinical suspicion and prompt initiation of empirical antibiotic therapy pending investigations’ results. Knowledge of one’s own NICU flora and antimicrobial susceptibility pattern guides in choosing correct antibiotic therapy to pediatrician. If this data is standard and comparable across different sites, then it also helps in formulating regional and National treatment guidelines. Present study was therefore undertaken to study microbial flora of present NICU and analyze their antimicrobial susceptibility pattern and formulate antimicrobial policy.

Methods: Data of blood culture isolates sent from suspected cases of neonatal sepsis received from January 2017 to July 2018 was analysed by “WHONET”.

Results: One hundred ninety-three non-repeat isolates were obtained from 992 blood culture samples. Coagulase negative Staphylococcus and K. pneumoniae were the most common isolates. Non albicans Candida were responsible for majority of fungal infection. There was an outbreak of C. pelliculosa for six months. Most of the bacteria were multidrug resistant (MDR). However, except one all other Candida isolates were sensitive to antifungal drugs.

Conclusions: WHO guidelines suggest use of penicillin and gentamicin for neonatal sepsis. But in present study, they were not found useful, instead amikacin, netilmicin and piperacillin-tazobactam were found useful and changes were made in antibiotic policy. Authors therefore recommend regular monitoring of antimicrobial susceptibility pattern followed by necessary changes in antibiotic policy for reasonable empirical therapy.


Schaffner J, Chochua S, Kourbatova EV, Barragan M, Wang YF, Blumberg HM, et al. High mortality among patients with positive blood cultures at a children's hospital in Tbilisi, Georgia. J Infect Develop Countries. 2009;3(4):267.

Kaistha N, Mehta M, Singla N, Garg R, Chander J. Neonatal septicemia isolates and resistance patterns in a tertiary care hospital of North India. J Infect Dev Ctries. 2009;4:55-7.

Sundaram V, Kumar P, Dutta S, Mukhopadhyay K, Ray P, Gautam V, Narang A. 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(1):46-50.

National Neonatal Perinatal Database. NNPD report 2002-03. Available at: http://www.newbornwhoccorg/pdf/nnpd_report_2002-03 PDF; 2005.

Fuchs A, Bielicki J, Mathur S, Sharland M, Van Den Anker JN. Antibiotic Use for Sepsis in Neonates and Children: 2016 Evidence Update. WHO Reviews. 2016.

Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Disk Susceptibility Tests. M02-ED12:2017.

Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Disk Susceptibility Tests. M02-ED13:2018.

Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing. M100-ED28: 2018.

Clinical and Laboratory Standards Institute (CLSI) Performance Standards for Antifungal Susceptibility Testing of Yeasts. M60-ED1:2017.

Agarwal R, Sankar J. Characterisation and antimicrobial resistance of sepsis pathogens in neonates born in tertiary care centres in Delhi, India: a cohort study. Lancet Global Health. 2016;4(10):e752-60.

Zakariya BP, Bhat V, Harish BN, Babu TA, Joseph NM. Neonatal sepsis in a tertiary care hospital in South India: bacteriological profile and antibiotic sensitivity pattern. Indian J Pediatr. 2011;78(4):413-7.

Dalal P, Gathwala G, Gupta M, Singh J. Bacteriological profile and antimicrobial sensitivity pattern in neonatal sepsis: a study from North India. Int J Res Med Sci. 2017;5(4):1541-5.

Das S, Bhattacharya M, Basu S, Majumdar S, Anshu K, Chatterjee A. The changing bacteriological profile with their antibiograms and outcome of culture positive neonatal sepsis in a tertiary care centre of Eastern India. EC Paediatr. 2018;7(4):209-21.

Agrawal A, Awasthi S, Ghanghoriya P, Singh S. Study of current status of bacteriological prevalence and profile in an inborn unit of SNCU in central India. Int J Contemp Pediatr. 2018;5:764-9.

Samaga MP. Prevalence of neonatal septicaemia in a tertiary care hospital in Mandya, Karnataka, India. Int J Res Med Sci. 2017;4(7):2812-6.

Apparao P, Nagdev J, Siddartha P. Most Common Isolates in Neonatal Sepsis, a Prospective Study in Tertiary Care Hospital. Int J Curr Microbiol App Sci. 2017;6(9):976-80.

Galhotra S, Gupta V, Bains HS, Chhina D. Clinico-bacteriological profile of neonatal septicemia in a tertiary care hospital. J Mahatma Gandhi Inst Med Sci. 2015;20:148-52.

Lin HC, Lin HY, Su BH, Ho MW, Ho CM, Lee CY, et al. Reporting an outbreak of Candida pelliculosa fungemia in a neonatal ICU. J Microbiol Immunol Infect. 2013;46:456-62.

Madhavan A, Jayalakshmi V, Sobha B. A case report of Candida pelliculosa sepsis in newborn nursery ICU. J Acad Clin Microbiol. 2013;15:32-3.






Original Research Articles