Blood culture positive sepsis and sensitivity pattern in NICU at a tertiary care neonatal centre
DOI:
https://doi.org/10.18203/2349-3291.ijcp20250760Keywords:
Antibiotic stewardship, Neonate, Sepsis, SensitivityAbstract
Background: This study aims to study blood culture positive neonatal sepsis and the sensitivity pattern of pathogenic organisms in a tertiary neonatal care hospital.
Methods: This retrospective observational cohort study was done in a tertiary care hospital. All the blood culture positive neonatal sepsis cases, excluding neonates with multiple congenital malformations, diagnosed during March 2023 to August 2023 (6 months) were analyzed.
Results: A total of 73 neonatal sepsis cases were diagnosed, among them 40 (54.7%) cases of gram-positive sepsis. In present study 61.6% cases were early onset sepsis, 41 (56%) babies were preterm and 49 (67%) babies were inborn. Staphylococcus aureus and Acinetobacter were the most common organisms in early onset and late onset sepsis respectively. The sensitivity of Gram-negative bacilli to colistin, minocycline and levofloxacin was 90%, 84% and 78% respectively. The sensitivity of gram-positive organisms to linezolid, vancomycin and teicoplanin were 92%, 73% and 70% respectively. Mortality rate among culture positive sepsis was 16.4%.
Conclusions: In the practice of modern neonatal care, multidrug organisms are emerging. By practicing antibiotic stewardship, infants can be protected from future multidrug resistance organisms.
Metrics
References
Sankar MJ, Neogi SB, Sharma J, Chauhan M, Srivastava R, Prabhakar PK. World Health Organization: Essential Newborn Care. In: A report of a Technical Working Group WHO. Geneva. 2009.
Report of the National Neonatal Perinatal Database (National Neonatology Forum), 2002-2003.
Clark RH, Bloom BT, Spitzer AR, Gerstmann DR. Empiric use of ampicillin and cefotaxime, compared with ampicillin and gentamicin, for neonates at risk for sepsis is associated with an increased risk of neonatal death. Pediatrics. 2006;117(1):67–74. DOI: https://doi.org/10.1542/peds.2005-0179
Agrawal R, Sankar MJ, Deorary AK, Paul VK, Sachdeva A. Sepsis in newborn in AIIMS NICU protocols 3rd ed. CBS Publishers. 2019;1:259-271.
Rath S, Panda SK, Nayak MK, Pradhan DD. Blood culture positive sepsis and sensitivity pattern in a tertiary care neonatal centre in eastern India. International J Contemp Ped. 2019;6(2):487. DOI: https://doi.org/10.18203/2349-3291.ijcp20190686
Bacteria R, Organisms Collee JG, Fraser AG, Marmion BP, Simmons A. Bacteria and Related Organisms. McCartney Practical Medical Microbiol. 2008;14:151–423.
Tallur SS, Kasturi AV, Nadgir SD. Clinico-bacteriological study of neonatal septicemia in Hubli. Indian J Pediatr. 2000;67:169-74. DOI: https://doi.org/10.1007/BF02723654
Bhakoo ON, Aggarwal KC, Mahajan CM, Walia BN. Septicemia in infants and children: a bacteriological study. Indian Pediatr. 1968;5(11):518-23.
Chaudhury A, Rao TV. Bacteraemia in a tertiary care urban hospital in south India. Indian J Pathol Microbiol. 1999;42(3):317–20.
Sharma A, Kutty CV, Sabharwal U, Rathee S, Mohan H. Evaluation of sepsis screen for diagnosis of neonatal septicemia. Indian J Pediatr. 1993;60(4):559–63. DOI: https://doi.org/10.1007/BF02751434
Esper F, Martin RJ, Fanaroff AA, Walsh CDC. Multidrug-resistant Organisms (MDRO) Management Guidelines. Infection Control. 2024. Available at: https://www.cdc.gov/infection. Accessed on 20th June,2024.
Greenberg JM, Haberman B, Narendran V, Nathan AT, Schibler K. Neonatal morbidities of prenatal and perinatal origin. Creasy and Resnik’s Maternal-Fetal Medicine: Principles and Practice, 8th Edition. Philadelphia: Elseiver. 2018:1309-33.
Khatua SP, Das AK, Chatterjee BD, Khatua S, Ghose B, Saha A. Neonatal septicemia. Indian J Pediatr. 1986;53(4):509–14. DOI: https://doi.org/10.1007/BF02749537
Kliegman RM, Behrman RE, Jenson HB, Stanton B. Nelson textbook of pediatrics E-book. 18th ed. Saunders. 2007.
Agarwal R, Deorari A. AIIMS Protocols in Neonatology. New Delhi, India: CBS Publishers & Distributors. 2019.
Huletsky A, Giroux R, Rossbach V, Gagnon M, Vaillancourt M, Bernier M, et al. New real-time PCR assay for rapid detection of methicillin-resistant Staphylococcus aureus directly from specimens containing a mixture of staphylococci. J Clin Microbiol. 2004;42(5):1875–84. DOI: https://doi.org/10.1128/JCM.42.5.1875-1884.2004
Forbes BA, Sahm DF, Weissfeld AS. Bailey and scott’s diagnostic microbiology. 12th ed. St. Louis, MO: Mosby. 2007.
Tsering DC, Chanchal L, Pal R, Kar S. Bacteriological profile of septicemia and the risk factors in neonates and infants in Sikkim. J Glob Infect Dis. 2011;3(1):42-5. DOI: https://doi.org/10.4103/0974-777X.77295
Sundaram V, Kumar P, Dutta S, Mukhopadhyay K, Ray P, Gautam V, et al. Blood Culture Confirmed Bacterial Sepsis in Neonates in a North Indian Tertiary Care Center: Changes over the Last Decade. 2009;62(1):46–50. DOI: https://doi.org/10.7883/yoken.JJID.2009.46
Oboodi R, Hashemi Z, Jaafarzadeh E, Yazdani N, Barzegar H. Bacterial etiology and antibiotic susceptibility profile in neonatal sepsis. Arch Pediatr Infect Dis. 2024;12(1):34. DOI: https://doi.org/10.5812/apid-136487
Sinha A, Tripathi S, Nigam N, Kumar M, Singh SN. Profile of neonates born with congenital birth defects in a tertiary care hospital of North India: An observational study. Clin Epidemiol and Global Health. 2022;14:100999. DOI: https://doi.org/10.1016/j.cegh.2022.100999
Zaidi AKM, Huskins WC, Thaver D, Bhutta ZA, Abbas Z, Goldmann DA. Hospital-acquired neonatal infections in developing countries. Lancet. 2005;365(9465):1175–88. DOI: https://doi.org/10.1016/S0140-6736(05)71881-X
Vergnano S, Sharland M, Kazembe P, Mwansambo C, Heath PT. Neonatal sepsis: an international perspective. Arch Dis Child Fetal Neonatal Ed. 2005;90(3):220-4. DOI: https://doi.org/10.1136/adc.2002.022863
Viswanathan R, Singh AK, Basu S, Chatterjee S, Sardar S, Isaacs D. Multi-drug-resistant gram-negative bacilli causing early neonatal sepsis in India. Arch Dis Child Fetal Neonatal Ed. 2012;97(3):182-7. DOI: https://doi.org/10.1136/archdischild-2011-300097
Roy S, Viswanathan R, Singh A, Das P, Basu S. Gut colonization by multidrug-resistant and carbapenem-resistant Acinetobacter baumannii in neonates. Eur J Clin Microbiol Infect Dis. 2010;29(12):1495–500. DOI: https://doi.org/10.1007/s10096-010-1030-z
Shrestha S, Shrestha NC, Dongol Singh S, Shrestha RPB, Kayestha S, Shrestha M, et al. Bacterial isolates and its antibiotic susceptibility pattern in NICU. Kathmandu Univ Med J. 2013;11(41):66–70. DOI: https://doi.org/10.3126/kumj.v11i1.11030
Characterisation and antimicrobial resistance of sepsispathogens in neonates born in tertiary care centres in Delhi, India: a cohort study. Lancet Global Health. 2016;4(10):752-760. DOI: https://doi.org/10.1016/S2214-109X(16)30148-6
Neopane A. Index JNPS: Vol 27/2, 28/1. 28/2, & 29/1. J Nepal Paed Soc. 2009;29(2):108-10. DOI: https://doi.org/10.3126/jnps.v29i2.2052
Shah P, Gadhvi K,Muliya B,Shah K,Neonatal sepsis-blood culture, antibiotic stewardship and clinico-bacteriological study. Int J Contemp Pediatr. 2020;7(12):2376-81. DOI: https://doi.org/10.18203/2349-3291.ijcp20205100