Neonatal sepsis: epidemiology, clinical spectrum, recent antimicrobial agents and their antibiotic susceptibility pattern
DOI:
https://doi.org/10.18203/2349-3291.ijcp20150523Abstract
Background: Neonatal sepsis is one of the most common causes of neonatal mortality in the developing world. This study aims to determine the incidence, the bacteriological profile of neonatal septicaemia, their antibacterial susceptibility pattern.
Methods: It is a prospective study, carried out in the tertiary care NICU of S.P. Medical College, Bikaner, Rajasthan, from January 2014 to October 2014. Blood culture specimens were collected from neonates, identification of organisms, their antibiotic susceptibility pattern detection was done.
Results: Gram negative organisms were more common (71.42%) than gram positive (28.57%). Klebsiella was the most common pathogen (48.21%) in both early and late onset septicemia. In third generation cephalosporins, only one organism (Strept. faecalis) is sensitive to ceftriaxone but cefoperazone and cefotaxim both have activity against Klebseilla and coagulase negative Staphylococcus. Ceftazidime showed better results and active against Klebseilla, E. coli, pseudomonas and unidentified gram negative bacilli. In aminoglycosides amikacin has much better results than gentamicin. Piperacillin had advantage over ampicillin. All organisms except E. coli showed sensitivity to cefotaxime. Vancomycin had good activity against gram positive organisms (enterococcus, CONS, MRSA). Neonatal mortality rate was 23.43%.
Conclusions: Neonatal sepsis is one of the major causes of morbidity and mortality in the newborns. Prematurity, low birth weight, prolonged rupture of membranes are major risk factors predisposing neonate to sepsis. This study, showed alarming results of antibiotic sensitivity patterns. The antibiotics which are routinely used like ampicillin and ceftriaxone showed poor activity against most of the organisms.
References
Bang AT, Bang RA, Bactule SB, Reddy HM, Deshmukh MD. Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. Lancet. 1999;354:1955-61.
Stoll BJ. The global impact of neonatal infection. Clin Perinatol. 1997;24:1-21.
National Neonatology Forum. Report of the National Neonatal Perinatal Database, 2002-03. Available at: http://www.nnfi.org/images/NNPD_2002-03.pdf.
Singh M, Narang A, Bhakoo ON. Predictive perinatal score in the diagnosis of neonatal sepsis. J Trop Pediatr. 1994;40(6):365-8.
Joseph CJ, Lian WB, Yeo CL. Nosocomial infections (late onset sepsis) in the neonatal intensive care unit (NICU). Proceedings Singapore Healthcare. 2012;21(4):238-44.
Choudhary P, Srivastava G, Agrawal DS, Sami L, Gupta S. Bacteriological study of neonatal infection. Indian Pediatr. 1975;12(6):459-63.
Khatua SP, Das AK, Chatterjee BD, Khatua S, Ghose B, Saha A. Neonatal septicemia. Indian J Pediatr. 1986;53:509-14.
Shitaye D, Asrat D, Woldeamanuel Y, Worku B. Risk factors and etiology of neonatal sepsis in Tikur Anbessa University Hospital, Ethiopia. Ethiop Med J. 2010;48(1):11-21.
Desai KJ, Malek SS. Neonatal septicemia: bacterial isolates and their antibiotics susceptibility patterns. NIRM. 2010;1(3):12-5.
Rathod SD, Bhatia PV, Patel PH, Pethani JD, Patel LR, Chauhan B. Bacteriological analysis and resistance pattern among various culture isolates from neonatal septicemia at tertiary care hospital of Ahmedabad. Nat J Med Res. 2012;2(4):466-9.
West BA, Peterside O. Sensitivity pattern among bacterial isolates in neonatal septicaemia in Port Harcourt. Ann Clin Microbiol Antimicrob. 2012;11:7.
