Clinical and bacteriological profile of neonatal sepsis: a prospective hospital-based study in a tertiary care hospital in eastern zone of West Bengal

Abstract

Background: Neonatal sepsis remains a leading cause of morbidity and mortality among neonates and clinical manifestations are non-specific. Delayed identification and inappropriate treatment remain as key factors causing high neonatal mortality. Increasing emergence of multidrug-resistant organisms reduces antibiotic options. Hence there is a need for institutional guidelines based on local microbial prevalence and their antibiotic susceptibility patterns.Methods: Blood cultures were collected from all suspected cases prior to the initiation of antimicrobial therapy. Neonatal sepsis with positive blood culture cases is included in the study.Results: Among 170 neonate blood culture was positive in 41 neonates (preterm - 71% and term neonate - 29%). Early onset neonatal sepsis (EONS) constituted 61% and Late onset neonatal sepsis (LONS) constituted 39%. Respiratory distress, hypoglycaemia, seizures, lethargy were more common presentations in EONS while cellulitis, sclerema, septic arthritis, loose stool, vomiting, blood in stool, hyperthermia and recurrent apnoea were more common presentations in LONS. Gram positive organisms constituted 51.2%, gram negative organisms were 46.3%, fungi were 9.8% of total pathogens. Among gram positive cons (43.9%) was most common while amongst gram negative Klebsiella (22%) was most common. Candida peliculosa was the most commonly isolated fungus. Cons, staphylococcus and enterococcus were seen to be 100% sensitive to linezolid. Enterococcus also showed 100% sensitivity to vancomycin, teicoplanin and tigecycline. Gram-positive bacteria showed the highest sensitivity to linezolid and vancomycin. Acinetobacter baumanii showed 80% sensitivity to gentamicin, 60% sensitivity to tigecycline and colistin. E. coli showed 66% sensitivity to tigecycline.Conclusions: We were able to analyze common causative pathogens, associated risk factors, and the antibiotic susceptibility pattern of neonatal sepsis.