Microorganisms Profile and Antimicrobial Resistance Pattern in Outborn Neonates in Northern India: A Hospital-Based Observational Study

Dhir, Shashi Kant; Sundaram, Venkataseshan; Gautam, Vikas; Munda, Vimal Singh; Tiewsoh, Jutang Babat Ain; Angurana, Suresh Kumar; Kumar, Jogender; Saini, Sushma Kumari; Dutta, Sourabh; Kumar, Praveen

doi:10.1093/tropej/fmab068

Cited by 5 publications

(3 citation statements)

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“…In India, clinicians over the past 10 years are turning more frequently to colistin as part of routine practice (19). Worryingly, our study showed higher rates of colistin resistance (14% overall, 30% in K. pneumoniae isolates) than previously reported in the literature on neonates in India (0-10%) (3,(20)(21)(22)(23)(24)(25). Polymyxins are classified as a "reserve" antibiotic class by the WHO (26).…”

Section: Discussionmentioning

confidence: 60%

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Emerging Antibiotic Resistance Patterns in a Neonatal Intensive Care Unit in Pune, India: A 2-Year Retrospective Study

et al. 2022

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Objective:Treating neonatal bloodstream infections and meningitis in South Asia remains difficult given high rates of antimicrobial resistance (AMR). To evaluate changing epidemiology of neonatal infections, we assessed pathogen-specific and clinical features of culture-proven infections in neonates admitted to a neonatal intensive care unit (NICU) in Pune, India.Materials and MethodsThis retrospective cohort study was performed in the King Edward Memorial Hospital and Research Center NICU over 2 years between January 1, 2017 and December 31, 2018. We included all neonates admitted to the NICU with positive blood or cerebrospinal fluid cultures. Demographic, clinical, and microbiologic data were collected from the medical record. We reviewed antimicrobial susceptibility testing (AST) of all isolates.ResultsThere were 93 culture-positive infections in 83 neonates, including 11 cases of meningitis. Fifteen (18%) neonates died. Gram-negative pathogens predominated (85%) and AST showed 74% resistance to aminoglycosides, 95% resistance to third/fourth generation cephalosporins, and 56% resistance to carbapenems. Resistance to colistin was present in 30% of Klebsiella pneumoniae isolates. Birth weight <1,000 g [odds ratio (OR) 6.0, p < 0.002], invasive respiratory support (OR 7.7, p = 0.001), and antibiotics at the time of culture (OR 4.2, p = 0.019) were associated with increased risk of mortality. Rates of AMR to all major antibiotic classes were similar between early onset and late onset infections. There was no association between carbapenem resistance and mortality.ConclusionIn our NICU in India, there are high rates of AMR among Gram-negative pathogens that are predominantly responsible for infections. Given higher colistin resistance in this cohort than previously reported, hospitals should consider routinely testing for colistin resistance.

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Section: Discussionmentioning

confidence: 60%

“…Of infections with a central line present at time of positive culture, the median for total duration of central line use was 6 days (IQR 4-12). The median time to culture positivity (from incubation to growth) was 22 h (IQR [19][20][21][22][23][24][25].…”

Section: Resultsmentioning

confidence: 99%

Emerging Antibiotic Resistance Patterns in a Neonatal Intensive Care Unit in Pune, India: A 2-Year Retrospective Study

et al. 2022

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“…[2] and Bipin Gupta et al [9]. These gram negative bacteria were resistant to third-generation cephalosporins [10].…”

Section: Discussionmentioning

confidence: 99%

Bacteriological Profile and Antibiogram Pattern in Isolates From Neonatal Sepsis in a Tertiary Care Hospital

DEVI,

MANJULA,

KAMALA

2024

Int J Curr Pharm Sci

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Objective: To determine the microbiological profile and their Antibiogram pattern in isolates from neonatal sepsis. Methods: This study was conducted from October 2022 to January 15th 2023. Total 663 blood samples received from NICU, which were processed in the department of microbiology Andhra Medical College, Visakhapatnam. Organisms were identified by conventional methods and an antibiotic susceptibility test was done by Kirby Bauer disc diffusion method as per CLSI guidelines. Results: Out of 663 samples 200 (30.16%) are culture positives, in which males are more affected than females, that is 103 (51.5%). Among the culture positives, the most predominant isolate was klebsiella species 106 (53%) followed by pseudomonas 28 (14%) Escherichia coli 28 (14%) Acinetobacter 24 (12%), MRSA 11 (0.05%), MSSA 3(0.015%). Regarding its antibiogram, klebsiella species and Escherichia coli were most sensitive to penicillins+beta lactamase inhibitors (83%), fluroquinolones (75%) and aminoglycosides (75%), respectively. Pseudomonas, Acinetobacter was sensitive to penicillins+betalactamase inhibitors (100%) and aminoglycosides (72%). Gram-positive organisms were mostly sensitive to vancomycin, linezolid, aminoglycosides (MRSA) and cefoxitin (MSSA). There was widespread resistance to third-generation cephalosporins (77.77%) among gram-negative organisms. Conclusion: Gram negative bacteria are the most common cause of neonatal sepsis and klebsiella species are the predominant pathogens. These gram negative bacteria were resistant to cephalosporins. Antibiogram helps as a guide to antimicrobial therapy and resistance to antibiotics, as it is the common problem that causes ineffectiveness of empirical treatment.

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Prevalence and antibiotic resistance pattern of bacteria from sepsis suspected neonates at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Sherif,

Abera,

Desta

2023

BMC Pediatr

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Background Neonatal sepsis is the major cause of neonatal mortality and morbidity, especially in low and middle-income countries. Continuous monitoring of pathogens and their antibiotic resistance pattern is crucial for managing neonatal sepsis. This study aimed to determine neonatal sepsis due to bacteria, antibiotic resistance patterns, associated risk factors and patient outcomes at St. Paul’s Hospital Millennium Medical College. Method An institutional-based cross-sectional study was conducted on 400 neonates suspected of sepsis at St. Paul’s Hospital Millennium Medical College from March 2020 to July 2020. A questionnaire was used to collect socio-demographic information, clinical parameters and potential risk factors from study participants. About 2ml of blood was drawn aseptically and inoculated into Tryptone Soya Broth at the patient’s bedside. Bacterial identification was performed by using standard microbiological techniques. The disk diffusion method was used to determine the antibiotic susceptibility patterns of each isolated bacteria. Data entry and analysis were done using Statistical Package for Social Sciences (SPSS) version 20 software. Bivariate and multivariable logistic regressions were used to assess associated risk factors of neonatal sepsis. A p-value less than 0.05 was considered statically significant with a 95% confidence interval. Results The overall prevalence of neonatal septicemia was 21% (84/400). Of these, 67 (79.8%) and 17 (20.2%) were gram-negative and gram-positive bacteria, respectively. Klebsiella spp, 37 (44%), E. coli 19 (21.6%) and Coagulase negative Staphylococci 13 (15.47%) were the leading cause of neonatal sepsis. Ciprofloxacin and amikacin were the most effective antibiotics for gram-negative and gram-positive bacteria. Multidrug resistance was observed in 84% of the bacterial isolates. Low birth weight and preterm were associated with neonatal septicemia (AOR = 49.90, 95% CI = 15.14-123.081, P = 0.002) and (AOR = 18.20, 95% CI = 6.835–27.541, P = 0.004) respectively. Conclusion Klebsiella spp and E. coli were frequently isolated bacteria in our study. The proportion of multidrug-resistance was significantly high. Most isolated bacteria were resistant to ampicillin, ceftazidime, cefotaxime and gentamycin, which indicates the necessity of continuous evaluation of antibiotic resistance rate.

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Microorganisms Profile and Antimicrobial Resistance Pattern in Outborn Neonates in Northern India: A Hospital-Based Observational Study

Cited by 5 publications

References 20 publications

Emerging Antibiotic Resistance Patterns in a Neonatal Intensive Care Unit in Pune, India: A 2-Year Retrospective Study

Emerging Antibiotic Resistance Patterns in a Neonatal Intensive Care Unit in Pune, India: A 2-Year Retrospective Study

Bacteriological Profile and Antibiogram Pattern in Isolates From Neonatal Sepsis in a Tertiary Care Hospital

Prevalence and antibiotic resistance pattern of bacteria from sepsis suspected neonates at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

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