Bacteriological profile and antibiotic susceptibility pattern of neonatal septicaemia in patients of neonatal intensive care unit, by BACTEC in a tertiary care hospital, Vadodara

Bhoomika Rajyaguru; Ahuti Pandya; Sandeep Nanda

doi:10.18203/2320-6012.ijrms20233035

Authors

Bhoomika Rajyaguru Department of Microbiology, All India Institute of Medical Sciences, Rajkot, Gujarat, India
Ahuti Pandya Department of Microbiology, Jawaharlal Nehru Medical college and KLE Hospital, Belagavi, Karnataka, India
Sandeep Nanda Department of Microbiology, SSG Hospital and Medical College Baroda, Vadodara, Gujarat, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20233035

Keywords:

Neonatal septicemia, BACTEC, Neonatal factors, Maternal factors

Abstract

Background: Neonatal septicemia is the major cause of mortality and morbidity in developing countries like India. It is an ongoing major global public health challenge with major contribution from neonatal sepsis. Objective were to study the prevalent organisms and their antibiotic susceptibility pattern of neonatal septicemia in NICU by BACTEC and neonatal factors and maternal factors associated with neonatal sepsis.

Methods: A cross-sectional study was carried out from December 2020 to September 2021. Blood samples were taken from the suspected cases admitted to NICU for culture and antimicrobial susceptibility test. A total of 103 blood culture-proven neonatal sepsis patients were enrolled in this study.

Results: Out of 103 neonates having blood culture-proven sepsis, septicemia was most common in males (53.4%), preterm (73.4%), and low birth weight (61.2%), with vaginal mode of delivery (51.5%). Neonatal septicemia was predominantly caused by gram-positive methicillin resistant coagulase negative Staphylococci (CONS) (28.15%). Among the all-gram-positive organism, vancomycin was the most sensitive drug followed by linezolid. For the gram-negative organisms, piperacillin/ tazobactam was the most sensitive drug followed by meropenem. Turnaround time of an automated BACTEC system for reporting culture positivity along with antimicrobial susceptibility was most commonly within 3 days (55.34%).

Conclusions: A high level of suspicion is needed on clinical grounds for the diagnosis of neonatal septicemia. Early onset septicemia is more common which can be curtailed by clean vaginal deliveries. Prematurity and low birth remain the major presentation for admission to NICU followed by respiratory distress syndrome. Maternal risk factors are associated with an increase in the incidence of neonatal septicemia. Septic screen markers are important in the presumptive diagnosis of sepsis in neonates along with the correlation of clinical presentation. The yield of reporting culture-proven sepsis neonates is more rapid with an automated BACTEC system as compared to conventional blood culture methods.

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References

WHO-Newborn health. Available at: https://www.who.int/health-topics/newborn-health. Accessed on 12 July 2023.

UNICEF- NFHS3/4, NCRB-2016. Available at: https://www.unicef.org/India/key-data. Accessed on 12 July 2023.

Millenium Development Goals, WHO. Available at: https://www.who.int/news-room/fact-sheets/detail/millennium-development-goals-(MDGs). Accessed on 12 July 2023.

Ganatra HA, Zaidi A. Neonatal Infections in the Developing World. Seminars Perinatol. 2010;34(6):416-25

Sepsis in a newborn. Available at: http://www.ncrckolkatta.orgp-172-188. Accessed on 12 July 2023.

National neonatal and perinatal database. Report 2002-2003. MMPD network. Supported by Indian Council of Medical Research, New Delhi. 2005.

Kumhar GD, Ramchandran VG, Gupta P. Bacteriological analysis of blood culture isolates from neonates in a tertiary care hospital in India. J Health Popul Nutr. 2002;20(4):343-7.

Anderson Berry A, Rosenkrantz T, Neonatal Sepsis. Available at: emedicine.medscape.com/article/ 978352-overviewandgynecologyofIndia. Accessed on 12 July 2023.

Zaidi A, Thaver D. Pathogens associated with sepsis in newborns and young infants in developing countries. J Pediatr Infect Dis. 2009;28(1):10-18.

Behrman RE, Kliegman RM, Jenson HB. Nelson Textbook of Pediatrics. 18th ed. Philadelphia: WB Saunders Company. 2011;629-48.

Waseem R, Khan M. Neonatal sepsis. Professional Med J. 2005;12(4):451-6.

Roy I, Jain A, Kumar M, Agarwal SK. Bacteriology of neonatal septicemia in a tertiary care hospital of northern India. Indian J Med Microbiol. 2002;20(3):156-9.

Vinodkumar CS, Neelagund YF. Perinatal risk factors and microbial profile of neonatal septicemia: A multicentre study. J Obstetr Gynecol India. 2008;58(1):32-40

Mane AK, Nagdeo NV, Thombare VR. Study of neonatal septicemia in a tertiary care hospital in rural Nagpur. J Recent Adv Appl Sci. 2010;25:19-24.

Isaacs D. Australasian Study Group for Neonatal Infections. A ten-year, multicentre study of coagulase-negative Staphylococcal infections in Australasian neonatal units. Arch Dis Child Fetal Neonatal Ed. 2003;88(2):F89-93.

Ozkan H, Cetinkaya M, Koksal N, Celebi S, Hacımustafaoglu M. Culture-proven neonatal sepsis in preterm infants in a neonatal intensive care unit over 7 years: coagulase-negative Staphylococcus as the predominant pathogen. Pediatr Int. 2014;56(1):60-6.

Shaw CK, Shaw P, Thapalial A. Neonatal sepsis bacterial isolates and antibiotic susceptibility patterns at a NICU in a tertiary care hospital in west Nepal: a retrospective analysis. Kathmandu Univ Med J (KUMJ). 2007;5(2):153-60.

Dalal P, Gathwala G, Gupta M, Singh J. Bacteriological profile and antimicrobial sensitivity pattern in neonatal sepsis: a study from North India. Int J Res Med Sci. 2017;5:1541-5.

Pokhrel B, Koirala T, Shah G, Joshi S, Baral P. Bacteriological profile and antibiotic susceptibility of neonatal sepsis in neonatal intensive care unit of a tertiary hospital in Nepal. BMC Pediatr. 2018;18(1):208.