Bacterial etiology and antimicrobial susceptibility pattern of neonatal sepsis at a tertiary care hospital in Nepal
DOI:
https://doi.org/10.18203/2349-3291.ijcp20211671Keywords:
Blood culture, Sepsis, Surveillance, NeonatesAbstract
Background: Sepsis is the second major cause of mortality among neonates. Present study was done to identify the common organisms which cause early and late onset neonatal sepsis in neonates admitted in our department and their antibiotic sensitivity patterns.
Methods: All neonates weighing more than 1500 gms and born to mothers with pre-existing infection, admitted to neonatal intensive care unit for suspected neonatal sepsis were included in the present study. They underwent blood culture and antibiotic sensitivity profiling.
Results: 210 newborns were admitted to the NICU of our department for suspected neonatal sepsis. Longer duration of rupture of membranes was found to be significantly associated with growth of organisms. Amongst the cases with gram positive organisms, most were due to Coagulase-negative staphylococci (CoNS) (n=25), followed by Staphylococcus aureus (n=14), and, Enterococcus (n=4). Gram negative organisms isolated constituted 17 organisms. Amongst the cases with gram negative organisms, mostly were due to Klebsiella (n=10), followed by Pseudomonas (n=5) and E. coli (n=2). The most common organism causing early onset sepsis was CoNS, while Staphylococcus aureus was the most common organism causing late onset sepsis. CoNS was fully sensitive to Vancomycin and Amikacin. Staphylococcus aureus was fully sensitive to Amikacin, α-hemolytic. Streptococcus were sensitive to Amikacin, Vancomycin and Piperacillin and Tazobactum and Enterococcus was sensitive to Amikacin and Vancomycin.
Conclusions: Antimicrobial surveillance of neonatal septicaemia is required to know the antibiotic sensitivity pattern and thus to formulate policies on use of antibiotics and to know the changing spectrum of antimicrobial sensitivity patterns.
References
Abubakar I, Tillmann T, Banerjee A. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Bur- den of Disease Study 2013. Lancet. 2015;385(9963):117-171.
Chan GJ, Lee AC, Baqui AH, Tan J, Black RE. Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis. PLoS Med. 2013;10(8): e1001502.
Aggarwal R, Sarkar N, Deorari AK, Paul VK. Sepsis in the newborn. Indian J Pediatr. 2001;68(12):1143-1147.
Schlapbach LJ, Kissoon N. Defining pediatric sepsis. JAMA Pediatr. 2018;172(4):312-314.
Karki S, Rai GK, Manandhar R. Bacteriological Analysis and Antibiotic Sensitivity Pattern of Blood Culture Isolates in Kanti Children Hospital. J Nepal Paediatr Soc. 2010;30:94-97.
Winn Jr W. Konemann’s color atlas and diagnostic text of microbiology. Lippencott Williams & Wilkins Publishers, Philadelphia, PA, Edition. 2006;6:945-1021.
CLSI. Performance Standards for Antimicrobial Susceptibility Testing. 27th ed. CLSI supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute. 2017.
Lamba M, Sharma R, Sharma D, Choudhary M, Maheshwari RK. Bacteriological spectrum and antimicrobial susceptibility pattern of neonatal septicaemia in a tertiary care hospital of North India. The Journal of Maternal-Fetal & Neonatal Medicine. 2016;29(24):3993-8.
Jajoo M, Kapoor K, Garg LK, Manchanda V, Mittal SK. To study the incidence and risk factors of early onset neonatal sepsis in an out born neonatal intensive care unit of India. J Clin Neonatol. 2015;4:91-5.
Thapa S, Sapkota LB. Changing Trend of Neonatal Septicemia and Antibiotic Susceptibility Pattern of Isolates in Nepal. International journal of pediatrics. 2019;3784529.-5.
