Bacterial agents and their antibiotic susceptibility in neonatal sepsis in high dependency NICU of Tertiary Care Hospital

Abstract

Background: The type of bacterial flora causing neonatal sepsis varies in different parts of world and the emerging of resistance to various antibiotics has been a challenge currently faced by microbiologists and neonatologist’s worldwide. The aim of this study was to isolate the bacteriological agent causing the neonatal sepsis and determination of their susceptibility to antibiotics. Methods: In this study, neonates suspected of sepsis who were admitted to Neonatal Intensive Care Unit (NICU) were assessed. Neonates with positive blood culture and with clinical signs of sepsis were enrolled in the study. The other parameters included: age, sex, birth weight, gestation, type of infection, type of isolated pathogen along with their antibiotic sensitivity and the outcome of disease. Results: 1440 neonates with suspected sepsis were included in study, out of 1440 patients, blood cultures were taken from all patients, 180cultures (12.5%) were reported as positive. in 32 cultures (17.7%) gram positive microbes were isolated while in 148 cultures (82.2%) gram negative microorganisms were detected.The mostcommon microorganisms isolated were; Klebsiella pneumonia (33.05%), Acintobacter Spp. (17.01%), Pseudomonas (13.26%), Escherishia-coli (8.75%),Coagulase negative staphylococci (CONS) (11.94%), MRSA (6.59%), Enterobacter (4.44%), Citrobacter (4.37%) and Enterococcus(2.36%). All of the klebsiella and enterobacter strains were resistant to ampicillin and gentamicin. Acintobacter Spp., and Citrobacter, were multidrug resistant with their sensitivity to imipenem was 40 to 45 % while for tigicycline was near 90%.The sensitivity of K. pneumonia and enterobacter to imipenem was: 90 and 94%, respectively.61.66% of our patients were preterm, early and late-onset sepsis was seen in 71 and 29% of patients respectively. Mortality rate was high 61.76% among preterm patients with sepsis while as overall mortality rate was 37.77%. Conclusion: In this study we found most common cause of bacterial sepsis was K. pneumoniae which was completely resistant to ampicillin and gentamicin. It therefore re-emphasis the need to change the empirical treatment of sepsis with ampicillin and gentamicin.

Abstract

Background: The type of bacterial flora causing neonatal sepsis varies in different parts of world and the emerging of resistance to various antibiotics has been a challenge currently faced by microbiologists and neonatologist’s worldwide. The aim of this study was to isolate the bacteriological agent causing the neonatal sepsis and determination of their susceptibility to antibiotics. Methods: In this study, neonates suspected of sepsis who were admitted to Neonatal Intensive Care Unit (NICU) were assessed. Neonates with positive blood culture and with clinical signs of sepsis were enrolled in the study. The other parameters included: age, sex, birth weight, gestation, type of infection, type of isolated pathogen along with their antibiotic sensitivity and the outcome of disease. Results: 1440 neonates with suspected sepsis were included in study, out of 1440 patients, blood cultures were taken from all patients, 180cultures (12.5%) were reported as positive. in 32 cultures (17.7%) gram positive microbes were isolated while in 148 cultures (82.2%) gram negative microorganisms were detected.The mostcommon microorganisms isolated were; Klebsiella pneumonia (33.05%), Acintobacter Spp. (17.01%), Pseudomonas (13.26%), Escherishia-coli (8.75%),Coagulase negative staphylococci (CONS) (11.94%), MRSA (6.59%), Enterobacter (4.44%), Citrobacter (4.37%) and Enterococcus(2.36%). All of the klebsiella and enterobacter strains were resistant to ampicillin and gentamicin. Acintobacter Spp., and Citrobacter, were multidrug resistant with their sensitivity to imipenem was 40 to 45 % while for tigicycline was near 90%.The sensitivity of K. pneumonia and enterobacter to imipenem was: 90 and 94%, respectively.61.66% of our patients were preterm, early and late-onset sepsis was seen in 71 and 29% of patients respectively. Mortality rate was high 61.76% among preterm patients with sepsis while as overall mortality rate was 37.77%. Conclusion: In this study we found most common cause of bacterial sepsis was K. pneumoniae which was completely resistant to ampicillin and gentamicin. It therefore re-emphasis the need to change the empirical treatment of sepsis with ampicillin and gentamicin.

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Mohsin Rashid MRLAM. Bacterial agents and their antibiotic susceptibility in neonatal sepsis in high dependency NICU of Tertiary Care Hospital. ijmhs [Internet]. 29Dec.2018 [cited 24Mar.2019];8(12):246-50. Available from: http://innovativejournal.in/index.php/ijmhs/article/view/2389
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Dec 29, 2018
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How to Cite
1.
Mohsin Rashid MRLAM. Bacterial agents and their antibiotic susceptibility in neonatal sepsis in high dependency NICU of Tertiary Care Hospital. ijmhs [Internet]. 29Dec.2018 [cited 24Mar.2019];8(12):246-50. Available from: http://innovativejournal.in/index.php/ijmhs/article/view/2389
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