Bacteriological Profile and Antibiogram of Community Acquired Neonatal Sepsis in a Tertiary Care Hospital; A Prospective Study

Abstract

Background: To isolate the pathogenic bacteria and to know the antibiotic sensitivity in the community acquired neonatal sepsis. Methods: It was a prospective study undertaken on 300 neonates suspected of community acquired neonatal sepsis admitted in Pediatrics Department of Government Medical College,Amritsar over a period of one year from January2014 to December 2014.All these cases fulfilled the inclusion criteria required for the study.Blood culture of these cases was performed by Mackie and McCartney method and antibiotic sensitivity by Kirley-Baner's disc diffusion method. Results: 227 (79%) cases showed positive blood culture.Gram negative isolates (N=156;65.82%) were more frequent than gram positive isolates (N=81;34.18%). Most common isolate was KlebsiellaPneumoniae (N=77%;32.48%) followed by Staphylococcus Aureus (N=66;27.84%), E.Coli(N=37;15.66%), Pseudomonas Aeroginosa (N=28;11.81%), Acinetobacter (N=14;5.90%), Enterococcus(N=8;3.37%) and Coagulase Negative Staphylococcus Aureus (N=7;2.99%). Both gram negative as well as gram positive isolates showed high resistance to ampicillin and gentamycin. Gram negative isolates were highly sensitive to Polymixin B and Meropenem whereas gram positive isolates were highly sensitive to Linezolid and Vancomycin. Conclusion: Gram negative bacteria were more frequent causes of community acquired neonatal septicemia than gram positive isolates. Both gram positive and negative isolates showed poor sensitivity towards conventional first line antibiotics, rather were mainly susceptible to higher antibiotics. So the knowledge of the pattern of bacteriological isolates and their antimicrobial susceptibility pattern can be very helpful for prompt treatment of such patients, to decrease neonatal morbidity and mortality as well as reducing the emergence of multi-drug resistant organisms.

Bacterial Profile of Neonatal Septicemia and Antibiotic Susceptibility Pattern of the Isolates in Tertiary Care Hospital, Dhaka, Bangladesh

“…Klebsiella pneumoniae was the commonest (41.9%) pathogen as isolated in our study. Similar reports have been observed by some other studies 4,5,6,11,16,29,30 . On the other hand, E.coli was found as the commonest bacteria in NS by few others 12,18,19,25 .…”

“…Out of 100 clinical neonatal septicemic case 31% (n=31) had growth on blood culture. This result was within the range of 19-79 percent of blood culture positivity as observed by other investigators 2,[4][5][6][7]14,15,20 . In our study the predominance of gramnegative 70.97% (n=22) organism in NS is similar to the observation of other investigators from India 2,6,15,17,20 , Pakistan 7,16 , Bangladesh 18,30 , Nepal 19 and Latin America 14 .…”

“…Neonatal septicemia, one of the leading cause of neonatal death is a life threating emergency 3,5,8,13 . Bacteriological profile of NS changes from region to region, center to center and time to time.…”

“…Bacteriological profile of NS changes from region to region, center to center and time to time. Alarming finding is that high proportion of organism are becoming resistant to commonly used antibiotics over the last few years 4,5 . This prospective study was carried out to determine the bacterial profile of NS and antibiotic sensitivity pattern of the isolated pathogens, to select an empirical protocal of antimicrobial therapy before the culture sensitivity report being available.…”

“…2,3 Till now NS remains the leading cause of neonatal death (30-50% of total neonatal death) despite significant progress in introduction of new antibiotics and latest techniques of early diagnosis and treatment. 4,5 The case fatality rates of NS ranges from 23-57%. 6,7,8 Spectrum of organisms causing NS changes from region to region, center to center and also with change of time.…”