DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20194748

Pattern of clinical manifestation and antibiotics sensitivity of Burkholderia Cepacia sepsis in Neonatal Intensive Care Unit of tertiary care centre of North India

Sharad Bansal, Rambabu Sharma, Narendra Jangir

Abstract


Background: Neonatal sepsis is a major cause of morbidity and mortality worldwide. Now a days, neonatal sepsis due to Burkholderia cepacia is on rise. This study was conducted to delineate clinical presentation and antibiotic sensitivity pattern from blood culture proven Burkholderia sepsis. Methods: In this retrospective analytical study, thirty-six neonates admitted to Neonatal Intensive Care Unit of a tertiary care hospital with blood culture proven Burkholderia sepsis were included. Clinical manifestation, laboratory findings and antibiotic sensitivity patterns of blood culture proven Burkholderia sepsis were analyzed.

Results: : All neonates were inborn and were admitted within 24 hours of birth. Difficulty in breathing was most common presenting symptom and seizure was second in number. There was no association with mode of delivery. Male to female ratio is 1.4:1. Progressive thrombocytopenia was the most consistent feature and in 6 patients also associated with anaemia. Average hospital stay was increased and more in preterm neonates. In this setup piperacillin + tazobactem was found to be most sensitive against Burkholderia cepacia and cotrimoxazole was 2nd in sensitivity.

Conclusions: Proper and timely identification of Non Fermentative Gram Negative Bacilli (NFGNB) other than Pseudomonas can help confine morbidity due to such infections. High degree of suspicion helps in early recognition. Efficient housekeeping is necessary to prevent nosocomial infections due to these pathogens.


Keywords


Antibiotic Sensitivity, Burkholderia , Neonatal, Nosocomial ,Septicemia

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References


Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, Cousens S, Mathers C, Black RE. Global, regional, and national causes of child mortality in 2000-13, with projections to inform post-2015 priorities: an updated systematic analysis. Lancet. 2015;385(9966):430-40.

Vergnano S, Sharland M, Kazembe P, Mwansambo C, Heath PT. Neonatal sepsis: an international perspective. Archives of Disease in Childhood-Fetal and Neonatal Edition. 2005;90(3):F220-4.

Edwards MS. Postnatal infections. In: Martin RJ, Fanaroff AA, Walsh MC, editors. Neonatal-Perinatal Medicine. 8th Ed. Philadelphia: Mosby Elsevier;2006:91-804.

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

Tiwari S, Pattanaik S, Kar A, Beriha SS. Burkholderia cepacia causing neonatal sepsis: a case series from a tertiary care hospital, Nepal. Med Coll J. 2015;17(1-2):92-4.

Isles A, Maclusky I, Corey M, Gold R, Prober C, Fleming P, et al. Pseudomonas cepacia infection in cystic fibrosis: an emerging problem. J Pediatr. 1984;104(2):206-10.

Mutlu M, Aslan Y, Saygin B, Yilmaz G, Bayramoglu G, Koksal I. Neonatal sepsis caused by gram-negative bacteria in a neonatal intensive care unit: a six year analysis. HK J Paediatr. (new series) 2011; 16: 253-57

Forbes BA. Daniel F./Weissfeld, Alice S./Brown. Nocardia, Streptomyces, Rhodococcus, Oerskovia, and Similar Organisms In: Bailey and Scott's Diagnostic Microbiology. Edited by Forbes BAS, Daniel F./Weissfeld, Alice S./Brown,: Elsevier; 2007:311-22.

Bhise SM, Rahangdale VA, Qazi MS. Burkholderia Cepacia an emerging cause of septicemia-an outbreak in a neonatal Intensive Care Unit from a tertiary care hospital of central India. IOSR J Dent Med Sci. 2013;10:41-3.

Patra S, Bhat R, Lewis LE, Purakayastha J, Sivaramaraju VV, Mishra S. Burkholderia cepacia sepsis among neonates. Indian J Pediatr. 2014;81(11):1233-6.

Gilbert DN, Moellering RC, Jr, Eliopoulos GM, Chambers HF, Saag MS. The Sanford Guide to Antimicrobial Therapy. 40th Ed. Sperryville, VA: Antimicrobial Therapy, INC; 2010.

Murray ST, Baltimore RS Nelson textbook of Pediatrics 1st South Asia Edition, Volume 2 chapter 205. India Elsevier.

Roy P, Ahmed N, Biswal I, Grover R. Antimicrobial susceptibility pattern of Burkholderia cepacia isolates from patients with malignancy. J Global Infect Dis. 2014;6(2):90.