DOI: https://dx.doi.org/10.18203/2349-3291.ijcp20222118
Published: 2022-08-24

A study on characterisation of antimicrobial resistance and antibiotic susceptibility pattern in late preterm and term neonates in a tertiary hospital, Imphal

Bishal Gurung, Dibin Joseph, T. Kambiakdik, C. Shyamsunder Singh, K. Ibochouba Singh

Abstract


Background: Neonatal sepsis is defined as a clinical syndrome of bacteremia with systemic signs and symptoms of infection in the first four weeks of life. It may further be divided into two main classes: early onset sepsis, which presents within the first 72 hours of birth and late onset sepsis, which usually presents after 72 hours after birth. The pattern of organisms causing neonatal sepsis has been constantly changing and the indiscriminate use of antibiotics had resulted in the emergence of multidrug resistant and virulent organisms. This study aimed to evaluate neonatal infections and the antibiotic susceptibility patterns.

Methods: An institution based cross sectional study in a NICU of a tertiary care hospital. Cases enrolled were both intra and extramural who got admitted during the study period. Informed consent was obtained from the parents/guardians.

Results: There were a total of 138 participants in the study. All of them tested positive for sepsis screen. Neonatal sepsis was more common in late pre-terms (57.2%) than terms (42.8%). Gram negative bacteria were the main causative agents with E. coli (9.4%) being the most common isolate followed by Acinetobacter baumanii (8%) and Klebsiella (8%). The most common gram-positive organism isolated was budding yeast cells (Candida spp.). Among gram positive bacteria the most common isolates were methicillin-resistant Staphylococcus aureus (MRSA) (5.8%) and coagulase-negative Staphylococci (CONS) (3.6%). Tigecycline and colistin were most sensitive antibiotics showing the least resistance to all organisms.

Conclusions: The antibiotic sensitivity patterns have changed and the morbidity load is higher in pre-terms compared to terms.


Keywords


Preterms, Sepsis, Antibiotic, MRSA, CONS

Full Text:

PDF

References


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.

Kumar M, Panda S, Mohapatra T. Study of Bacteriological Profile of Neonatal Sepsis in a Tertiary Care Hospital: Prevalent micro-organisms and their Susceptibility patterns. ISOR-JDMS. 2017;16(8):79-81.

Singh KH, Sharja P, Khandwal O. Bacteriological profile of neonatal sepsis in neonatal intensive care unit (NICU) in a tertiary care hospital: prevalent bugs and their susceptibility patterns. EJPMER. 2016;3(3):241-5.

Barton M, O’Brein K, Robison JL, Davies DH, Simpson K, Asztalos E. Invasive candidiasis in low-birth-weight preterm infants: risk factors, clinical course and outcome in a prospective multicenter study of cases and their matched controls. BMC Infect Dis. 2014;14:327.

Kaishta N, Mehta M, Singla N, Garg R, Chander J. Neonatal septicaemia and resistance patterns in a tertiary care hospital of North India. J infect Dev Ctries. 2010;4(1):55-7.

Samaga PM, Sumangala B. Bacteriological profile of neonatal septicaemia in MIMS, Mandya, Karnataka, India. Int J Curr Microbiol App Sci. 2016;5(3):495-501.

Ingale DH, Kongre AV, Bhardwaj SR. A study of infections in neonatal intensive care unit at a tertiary hospital. Int J Contemp Pediatr. 2017;4(4):1349-56.

Jayasimha V, Raghukumar KG, Kum CSV, Patil SS, Basavarajappa GK. Neonatal septicaemia and antibiogram: Paediatrician’s challenge. RGUHS Med Sci. 2017;7(1):12-5.

Karki S, Rai GK, Manadhar R. Bacteriological analysis and antibiotic sensitivity pattern of blood culture isolates in Kanti Children Hospital. J Nepal Paediatr Soc. 2010;30(2):94-7.

Manisha S, Pratibha D. Clinical and microbiological profile of neonatal infections in the Neonatal Intensive Care Unit. Int Res J Med Sci. 2013;1(8):15-8.

Jhajhria A, Yadav KA, Parihar G, Gupta SP. Bacteriological profile and antimicrobial susceptibility of blood culture in a tertiary care hospital Ajmer. Int J Med Health Res. 2018;4(3):07-11.

Investigators of the Delhi National Infection Study (DeNIS) collaboration. Characterisation and antimicrobial resistance of sepsis pathogens in neonates born in tertiary care centres in Delhi, India. Lancet Glob Health. 2016:4;4752-60.

Shaw CK, Shaw P, Thapalial. Neonatal sepsis bacterial isolate and antibiotic susceptibility patterns at a NICU in a tertiary care hospital in western Nepal: A retrospective analysis. Kathmandu Univ Med J. 2007;5(18):153-60.

Pokhrel B, Koirala T, Shah G, Joshi S, Baral P. Bacteriological profile and antibiotic susceptibility of neonatal sepsis in neonatal intensive care unit of a tertiary care hospital in Nepal. BMC Pediatr. 2018;18:208.

Bhamare BS, Alaka K, Iyer V, Bjardwaj R. Study of prevalence of methicillin and vancomycin resistance in multidrug resistant coagulase negative Staphylococci. Int J of Healthcare BioMed Res. 2014;2(3):67-72.

Roy I, Jain I, Kumar M, Agarwal SK. Bacteriology of neonatal septicaemia in a tertiary care hospital of northern India. Indian J Med Microbiol. 2002;20(3):156-9.

Gupta S, Dingh KV, Singhal S, Chowdhary P. Neonatal sepsis in a tertiary care hospital in Delhi, India: study of microbial profile and antimicrobial susceptibility pattern. Int J Contemp Pediatr. 2019;6(2):384-9.

Agarwal 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(3):764-9.

Ingale HD, Kongre VA, Bharadwaj RS. A study of infections in neonatal intensive care unit at a tertiary care hospital. Int J Contemp Pediatr. 2017;20174(4):1349-56.

Kim WY, Hong SB. Sepsis and acute respiratory distress syndrome: recent update. Tuberculosis Respiratory dis. 2016;79(2):53-7.

Stapleton RD, Wang BM, Hudson LD, Rubenfeld GD, Caldwell ES, Steinberg KP. Causes and timing of death in patients with ARDS. Chest. 2005;128:525-32.

Sabeeh JD. Predictors of mortality outcome in neonatal sepsis. Med J Basrah University. 2007;25(1):11-8

Shrestha S, Adhikari N, Rai BK, Shreepaili A. Antibiotic resistance pattern of bacterial isolates in neonatal care unit. J Nepal Med Asso. 2010;50(180):277-81.

Shehab El-Din EM, El-Sokkary MM, Bassiouny MR, Hassan R. Epidemiology of neonatal sepsis and implicated pathogens: a study from Egypt. Biomed Res Int. 2015;2015:11.

Thakur S, Thakur K, Sood A, Chaudhary S. Bacteriological profile and antibiotic sensitivity pattern of neonatal septicaemia in a rural tertiary care hospital in North India. Indian J Med Microbiol. 2016;34(1):67-71.

Mustafa M, Ahmed SL. Bacteriological profile and antibiotic susceptibility patterns in neonatal septicemia in view of emerging drug resistance. J Med Allied Sci. 2014;4(1).

Jasani B, Kannan S, Nanavati R, Gogtay NJ, Thatte U. An audit of colistin use in neonatal sepsis from a tertiary care centre of a resource-limited country. Indian J Med Res. 2016;144(3):433-9.

Krause KM, Serio AW, Kane TR, Connolly LE. Aminoglycosides: an overview. Cold Spring Harb Perspect Med. 2016;6(6):18.

Thapa S, Sapkota LB. Changing trend of neonatal septicemia and antibiotic susceptibility pattern of isolates in Nepal.Int J Pediatr. 2019;2019:7.

Gonzalez III LS, Spencer JP. Aminoglycosides: a practical review. Am Fam Physician. 1998;58(8):1811-20.

Das N, Madhavan J, Selvi A, Das D. An overview of cephalosporin antibiotics as emerging contaminants: a serious environmental concern. Biotech. 2019;9(6):1-14.

Downie L, Armiento R, Subhi R, Kelly J, Clifford V, Duke T. Community-acquired neonatal and infant sepsis in developing countries: efficacy of WHO's currently recommended antibiotics-systematic review and meta-analysis. Arch Dis Child. 2013;98(2):146-54.

Korang SK, Safi S, Gluud C, Lausten-Thomsen U, Jakobsen JC. Antibiotic regimens for neonatal sepsis-a protocol for a systematic review with meta-analysis. Syst Rev. 2019;8(1):1-3.

Dinos GP. The macrolide antibiotic renaissance. Br J Pharmacol. 2017;174(18):2967-83.

Song JH, Chang HH, Suh JY, Ko KS, Jung SI, Oh WS et al. Macrolide resistance and genotypic characterization of Streptococcus pneumoniae in Asian countries: a study of the Asian Network for Surveillance of Resistant Pathogens (ANSORP). J Antimicrob Chemother. 2004;53(3):457-63.