Neonatal septicemia: isolates and their sensitivity pattern with emergence of Citrobacter septicemia


  • Ram Sunder Sharma Department of Pediatrics, SNCU, G. R. Medical College Gwalior, Madhya Pradesh
  • Manali Tiwari Department of Pediatrics, AMRI Hospital, Kolkata
  • Ram Pratap Bansal Department of Pediatrics, SNCU, G. R. Medical College Gwalior, Madhya Pradesh



Neonatal septicemia, Antibiotic resistance, Citrobacter


Background: Septicemia in neonates refers to bacterial infection documented by positive blood culture in the first 28 days of life and is one of the leading causes of neonatal mortality and morbidity in India. The aim of the study was to identify clinical neonatal sepsis cases and isolate responsible microorganism by blood culture and determine sensitivity pattern of isolates in a tertiary care hospital.

Methods: It is a hospital based retrospective study involving neonates admitted in department of paediatrics at a medical college hospital. Two hundred twenty five blood samples were collected for blood culture from neonates with clinical sepsis with standard protocol. Isolation of microorganism and antibiotic sensitivity testing was done with disc diffusion method.

Results: Blood culture reports were positive in 43.55% cases of clinical sepsis. Among positive blood culture reports gram negative isolates were more frequent (75.51%). Most commonly isolated was Klebsiella species (34.70%), most common gram positive isolate was Streptococcus (10.20%). Prevalence of Citrobacter species isolation was 16.12%. Among gram negative isolates best overall sensitivity was towards levofloxacin (97.3%) followed by amikacin (60.8%). Sensitivity to piperacillin+tazobactam (20.3%) and cefoperazone+sulbactam (23%) were very low. Gram positive isolates had best sensitivity to vancomycin and linezolid.

Conclusions: Gram negative organisms (Klebsiella species, Citrobacter species), Streptococcus, Staphylococcus are leading cause of neonatal sepsis. There are high levels of resistance to routinely used antibiotics among them. Therefore results of this study suggest that we should revise our antibiotic treatment policy and emphasize on rationale antibiotic use.



Stoll BJ, Hansen N. Infections in VLBW Infants: Studies From The NICHD Neonatal Research Network. Semin Perinatol. 2003;27:293-301.

Stoll BJ, Hansen NI, Adams-Chapman I, Fanaroff AA, Hintz SR, Vohr B et al. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infections. JAMA. 2004;292:2357-65.

Ghai OP. Ghai Essential Pediarics: Introduction to paediatrics. 8th edition. Delhi-92; CBS Publ:2013. P.2.

Bang AT, Bang RA, Bactule SB, Reddy HM, Deshmukh MD. Effect of home-based neonatalvcare and management of sepsis on neonatal mortality: field trial in rural India. Lancet. 1999;354:1955-61.

Stoll BJ. The global impact of neonatal infection. Clin Perinatol. 1997;24:1-21.

Deorari AK. Changing pattern of bacteriologic profile in neonatal sepsis among intramural babies. J. Neonatol. 2006;20(1):8-15.

Desai KJ, Malek SS. Neonatal Septicemia: Bacterial Isolates & Their Antibiotics Susceptibility Patterns. NJIRM. 2010;1(3):13-5.

Jain A, Roy I, Gupta MK, Kumar M, Agarwal SK. Prevalence of extended-spectrum beta lactamase producing Gram-negative bacteria in septicaemic neonates in a tertiary care hospital. Journal of Medical Microbiology. 2003;52:421-5.

Chandel DS, Johnson JA, Chaudhry R, Sharma N, Shinkre N, Parida S, et al. Extended-spectrum b-lactamase-producing Gram-negative bacteria causing neonatal sepsis in India in rural and urban settings.Journal of Medical Microbiology. 2011;60:500-7.

Kamble R, Ovhal R. Bacteriological profile of neonatal septicaemia. Int J Curr Microbiol App Sci. 2015;4(2):172-82.

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(2):306-9.

Nayar N, Shukla I, Sultan A. Epidemiology, Prevalence and Identification of Citrobacter Species in Clinical Specimens in a Tertiary Care Hospital in India. International Journal of Scientific and Research Publications. 2014;4(4):1-6.

Bhat YR, Lewis LE, and KEV. 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. doi: 10.1186/1824-7288-37-32.




How to Cite

Sharma, R. S., Tiwari, M., & Bansal, R. P. (2016). Neonatal septicemia: isolates and their sensitivity pattern with emergence of Citrobacter septicemia. International Journal of Research in Medical Sciences, 4(4), 1128–1131.



Original Research Articles