Bacteriological profile and antimicrobial sensitivity pattern in neonatal sepsis: a study from North India

Authors

  • Poonam Dalal Department of Pediatrics, PGIMS, Rohtak, Haryana, India-124001
  • Geeta Gathwala Department of Pediatrics, PGIMS, Rohtak, Haryana, India-124001
  • Mohit Gupta Department of Pediatrics, PGIMS, Rohtak, Haryana, India-124001
  • Jasbir Singh Department of Pediatrics, PGIMS, Rohtak, Haryana, India-124001

DOI:

https://doi.org/10.18203/2320-6012.ijrms20171261

Keywords:

Antibiotic sensitivity, Microbial flora, Neonatal sepsis, Resistance

Abstract

Background: Neonatal sepsis is a leading cause of neonatal mortality and continues to be a formidable problem for neonatologists and pediatricians world over.  Knowledge of microbial flora and their susceptibility will help us to decide empirical treatment for the neonatal sepsis. The objective of this study was to determine the bacteriological flora prevalent in NICU and the antimicrobial sensitivity pattern.

Methods: The blood culture reports of all the neonates with culture proven neonatal sepsis during the period July 2010 to September 2013 were reviewed retrospectively. A retrospective review in tertiary care teaching medical college. The data was entered in Excel sheets and percentages of various outcomes were calculated.

Results: A total of 28,927 babies were born during the study period and 336 among them had positive blood culture. The incidence of neonatal sepsis was 11.62 per 1,000 live births. Three hundred fifty- six microbes were isolated, out of which 50% presented as early onset sepsis and remaining as late onset sepsis. Pseudomonas aeruginosa was the most common organism encountered in both early (43.82%) and late onset sepsis (51.35%). Gram negative bacilli were sensitive to carbapenems (92%) followed by piperacillin-tazobactam (90%) whereas linezolid (90%) was most sensitive antimicrobial for gram positive cocci.

Conclusions: Pseudomonas was most commonly isolated in both early and late onset sepsis.  Gram negative bacilli were most sensitive to piperacillin-tazobactam and the carbapenems whereas linezolid and vancomycin were most effective against the gram-positive cocci. Resistance to third generation cephalosporins was rampant. Continuous surveillance for microbial flora, their antibiotic susceptibility, rational use of antibiotics and the strategy of antibiotic cycling may be of help to curtail emerging antimicrobial resistance.

Author Biographies

Poonam Dalal, Department of Pediatrics, PGIMS, Rohtak, Haryana, India-124001

Associate Professor, Department of Pediatrics

Geeta Gathwala, Department of Pediatrics, PGIMS, Rohtak, Haryana, India-124001

Senior Professor and Head, Department of Pediatrics

Mohit Gupta, Department of Pediatrics, PGIMS, Rohtak, Haryana, India-124001

Senior Resident, Department of Pediatrics

Jasbir Singh, Department of Pediatrics, PGIMS, Rohtak, Haryana, India-124001

Senior Resident, Department of Pediatrics

References

Report of the National Neonatal Perinatal Database (National Neonatology Forum) 2002-03. New Delhi: National Neonatology Forum NNPD Network; 2005:70.

Koneman EW, Allen SD, Janda WM, Schreckenberger PC, Winn WC. Introduction to microbiology. In: Colour Atlas and Textbook of Diagnostic Microbiology, 6th ed. Philadelphia: Lippincott; 1997:171-566.

Bhat YR, Lewis LES Vandana KE. Bacterial isolates of early-onset neonatal sepsis and their antibiotic susceptibility pattern between 1998 and 2004: an audit from a center in India. Ital J Pediatr. 2011;37:32-7.

Shrestha S, Shrestha NC, Singh S, Shrestha RPB, Kayestha S, Shrestha M et al. Bacterial isolates and its antibiotic susceptibility pattern in NICU. Kathmandu Univ Med J. 2013;41:66-70.

Kuruvilla KA, Thomas N, Jesudasan MV, Jana AK. Neonatal group B streptococcal bacteraemia in India: ten years’ experience. Acta Paediatr. 1999;88:1031-2.

Patel D, Nimbalkar A, Sethi A, Kungwani A, Nimbalkar S. Blood culture isolates in neonatal sepsis and their sensitivity in Anand district of India. Indian J Pediatr. 2014;81:785-90.

Fahmey SS. Early-onset sepsis in a neonatal intensive care unit in Beni Suef, Egypt: bacterial isolates and antibiotic resistance pattern. Korean J Pediatr. 2013;56:332-7.

Jyothi P, Basavaraj MC, Basavaraj PV. Bacteriological profile of neonatal septicemia and antibiotic susceptibility pattern of the isolates. J Nat Sci Biol Med. 2013;4:306-9.

Saleem AF, Qamar FN, Shahzad H, Qadir M, Zaidi AKM. Trends in antibiotic susceptibility and incidence of late-onset Klebsiella pneumoniae neonatal sepsis over a six-year period in a neonatal intensive care unit in Karachi, Pakistan. Int J Infect Dis. 2013;17:961-5.

Nepal HP, Acharya A, Gautam R, Shrestha S, Paudel R. Bacteriological profile of neonatal septicemia cases and the antimicrobial resistance pattern in a tertiary care hospital of central Nepal. Int J of Biomed Res. 2013;4:26-31.

Draz NI, Taha SE, Shady NMA, Ghany YSA. Comparison of broad range 16S rDNA PCR to conventional blood culture for diagnosis of sepsis in the newborn. Egyptian J Med Human Genetics. 2013;14:403-11.

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

Viswanathan R, Singh AK, Ghosh C, Dasgupta S, Mukherjee S, Basu S. Profile of neonatal septicaemia at a district-level sick newborn care unit. J Health Popul Nutr. 2012;30:41-8.

Tsering DC, Chanchal L, Pal R, Kar S. Bacteriological profile of septicemia and the risk factors in neonates and infants in Sikkim. J Global Infect Dis. 2011;3:425.

Ahmed NU, Chowdhury MA, Hoque M, Darmstadt GL. Clinical and bacteriological profile of neonatal septicemia in a tertiary level pediatric hospital in Bangladesh. Indian Pediatr. 2002;39:1034-9.

Tallur SS, Kasturi AV, Nadgir SD, Krishna BVS: Clinico-bacteriological study of neonatal septicemia in Hubli. Indian J Pediatr. 2000;67:169-74.

Sheth KV, Patel TK, Tripathi CB. Antibiotic sensitivity pattern in neonatal intensive care unit of a tertiary care hospital of India. Asian J Pharm Clin Res. 2012;5:46-50.

Parmar H, Dholakia A, Vasavada D, Singhala H. The current status of antibiotic sensitivity of Pseudomonas aeruginosa isolated from various clinical samples. Int J Res Med. 2013;2;1-6.

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Published

2017-03-28

How to Cite

Dalal, P., Gathwala, G., Gupta, M., & Singh, J. (2017). Bacteriological profile and antimicrobial sensitivity pattern in neonatal sepsis: a study from North India. International Journal of Research in Medical Sciences, 5(4), 1541–1545. https://doi.org/10.18203/2320-6012.ijrms20171261

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Original Research Articles