Clinico-bacteriological profile of neonatal sepsis

Authors

  • Rashmi P. Department of Paediatrics, Father Muller Medical College and Hospital, Mangaluru, Karnataka, India
  • Praveen B. K. Department of Paediatrics, Father Muller Medical College and Hospital, Mangaluru, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20190732

Keywords:

Antibiotic stewardship, Blood culture, Neonatal sepsis

Abstract

Background: Neonatal sepsis is the commonest cause of neonatal mortality responsible for about 30-50% of total neonatal deaths in developing countries. Surveillance of causative organisms and their antibiotic sensitivity pattern promotes rational use of antibiotics and antibiotic stewardship.

Methods: A retrospective study, relevant data regarding the neonates diagnosed with culture positive sepsis was obtained from the case records during the period from July 2014 to June 2017. Culture positive sepsis was defined as isolation of bacterial pathogen from blood in neonates with clinical suspicion of sepsis.

Results: Of the 414 neonates with clinical suspicion of sepsis, 110 neonates had blood culture positive sepsis. Sepsis was predominant in males (64.5%). Low birth weight (47.2%) and prematurity (40.9 %) were important neonatal risk factors for sepsis. Early onset sepsis occurred in 58.1% of the cases and late onset sepsis in 41.9% of the neonates. Gram-positive cocci constituted 67.52% of all isolates and gram negative 30.76%. The most frequently isolated organism in blood was methicillin resistant coagulase negative staphylococcus(MRCONS) (32.47%). Gram positive organisms included MRCONS, methicillin resistant Staphylococci aureus (MRSA), group B Streptococci (GBS), Staphylococcus aureus and Enterococci. Among Gram-negative organisms, Acinetobacter was most frequently isolated followed by Klebsiella, Escherichia coli, Pseudomonas, Citrobacter and Burkholderia species. The mortality in the study group was 13.5%. Gram negative organisms were most resistant to ampicillin and cephalosporins. Gram positive isolates were least resistant to vancomycin and linezolid.

Conclusions: Gram positive sepsis was the most common type of sepsis among the neonates, although mortality was more in gram negative sepsis.

References

Gerdes J. Diagnosis and management of bacterial infections in the neonate. Pediatric Clinics North America. 2004;51(4):939-59.

Zea-Vera A, Ochoa T. Challenges in the diagnosis and management of neonatal sepsis. J Tropical Pediatr. 2015;61(1):1-13.

Viswanathan R, Singh A, Basu S, Chatterjee S, Sardar S, Isaacs D. Multi-drug resistant gram-negative bacilli causing early neonatal sepsis in India. Archives Dis Childhood - Fetal Neonatal Edition. 2011;97(3):F182-7.

Bhat Y R, Lewis L, KE V. Bacterial isolates of early-onset neonatal sepsis and their antibiotic susceptibility pattern between 1998 and 2004: an audit from a center in India. Italian J Pediatr. 2011;37(1):32.

World Health Organisation. Neonatal and perinatal mortality: country, regional and global estimates. Geneva: World Health Organisation; 2006.

NNPD Network. National neonatal-perinatal database: report 2002-2003 / NNPD Network, Indian Council of Medical Research, National Neonatology Forum. New Delhi: Nodal Centre, AIIMS, 2005.

Peymaneh TA, Hossein E, Peyman S. Is ceftizoxime an appropriate surrogate for amikacin in neonatal sepsis treatment? A randomized clinical trial. Acta Medica Iranica. 2011;49(8):499-503.

Isaacs D, Royle J. Intrapartum antibiotics and early onset neonatal sepsis caused by group B Streptococcus and by other organisms in Australia. Pediatr Infectious Dis J. 1999;18(6):524-8.

Kalathia M, Kalathia I, Shingala P, Parmar P, Parikh Y. Study of umbilical cord blood culture in diagnosis of early-onset sepsis among new-borns with high-risk factors. J Clinical Neonatol. 2013;2(4):169-72.

Bansal S, Jain A, Agarwal J, Malik G. Significance of coagulase negative staphylococci in neonates with late onset septicemia. Indian J Pathol Microbiol. 2004;47(4):586-8.

Roy P, Kumar A, Faridi M, Kaur R, Kashyap B. Clinico-bacteriological Profile of Neonates Born with Risk Factors of Septicemia. Indian J Neonatal Med Res. 2014;2(1):1- 6.

Mohsen L, Ramy N, Saied D, Akmal D, Salama N, Abdel Haleim M et al. Emerging antimicrobial resistance in early and late-onset neonatal sepsis. Antimicrobial Resistance Infection Control. 2017;6(1).

Jain N, Jain V, Maheshwari S. Clinical profile of neonatal sepsis. Kathmandu University Med J l. 2003;1(2):117-20.

Galhotra S, Gupta V, Bains H, Chhina D. Clinico-bacteriological profile of neonatal septicemia in a tertiary care hospital. J Mahatma Gandhi Institute Med Sci. 2015;20(2):148.

Reddy K, Sailaja K, Ashok A, Poojitha K. Clinico-bacteriological profile of neonatal sepsis in rural tertiary care hospital. Int J Contemporary Pediatr. 2017;4(4):1259-62.

Madavi D, Aziz F, Agrawal G. Clinico-bacteriological profile and antibiotic sensitivity pattern of neonatal septicaemia-A prospective observational study. Int J Current Res Review. 2015;7(5):13-20.

Goyal M, Jain R, Mittal J, Vijay Y, Mehru N. A clinico-bacteriological profile, antimicrobial susceptibility and outcome of neonatal sepsis in tertiary care hospital, Jaipur. Indian J Basic Applied Med Res. 2018;7(2):256-69.

Ozkan H, Cetinkaya M, Koksal N, Celebi S, Hacımustafaoglu M. Culture-proven neonatal sepsis in preterm infants in a neonatal intensive care unit over a 7-year period: Coagulase-negative staphylococcusas the predominant pathogen. Pediatr Int. 2014;56(1):60-6.

Sethi A, Srigade V, Dharmateja G. Neonatal sepsis: Risk factors, clinical and bacteriological profile, and antibiotic sensitivity. Indian J Child Health. 2018;5(6):432-7.

Vergnano S. Neonatal sepsis: an international perspective. Archives Dis Childhood- Fetal Neonat Edition. 2005;90(3):F220-4.

Aku F, Akweongo P, Nyarko K, Sackey S, Wurapa F, Afari E et al. Bacteriological profile and antibiotic susceptibility pattern of common isolates of neonatal sepsis, Ho Municipality, Ghana-2016. Maternal Health Neonatol Perinatol 2018;4(1).

Li Z, Xiao Z, Li Z, Zhong Q, Zhang Y, Xu F. 116 cases of neonatal early-onset or late-onset sepsis: A single center retrospective analysis on pathogenic bacteria species distribution and antimicrobial susceptibility. Int J Clinical Experimental Med. 2013;6(8):693.

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-e60.

Iregbu K, Medugu N. Trends in profiles of bacteria causing neonatal sepsis in Central Nigeria Hospital. African J Clinical Experimental Microbiol. 2016;18(1):49.

Upadhyay A, Aggarwal R, Kapil A, Singh S, Paul V, Deorari A. Profile of Neonatal Sepsis in a tertiary care neonatal Unit from India.: A retrospective study. J Neonatol. 2006;20(1):50-7.

Downloads

Published

2019-02-23

Issue

Section

Original Research Articles