Published: 2019-09-25

Neonatal septicemia: bacteriological profile in a tertiary level hospital in South India

Soja Vijayan, Deepa S. Narayanan, Gopalan A. Velayudhan Nair


Background: Early onset bacterial sepsis remains a major cause of neonatal morbidity and death. The choice of antibiotic for an infant with sepsis depends on the predominant bacterial pathogens and the antibiotic susceptibility profiles for the microorganisms causing disease in a particular geographic region. The purpose of this study was to analyze the bacteriological profile and antibiotic sensitivity pattern of neonatal septicemia in our neonatal unit.

Methods: A descriptive cross sectional study carried was out at the NICU of a tertiary level hospital in South India for a period of one year.

Results: Clinically suspected septicemia comprised 18.14% of total NICU admissions. Organism was isolated by blood culture in 14.9% of cases. The most common organisms causing septicemia were Coagulase negative Staphylococci, Klebsiella and Staphylococcus aureus. Gram positive isolates were most sensitive to Vancomycin (100%) while the gram negative isolates were most sensitive to Amikacin. Resistance to Crystalline Penicillin, Ampicillin  and 3rd generation cephalosporins was high.

Conclusions: The most common organism isolated in septicemia was Coagulase negative staphylococcus in our NICU. Gram positive isolates were most sensitive to Vancomycin (100%) while the gram negative isolates were most sensitive to Amikacin. High resistance to commonly used antibiotics is worrisome. There should be a constant surveillance of the common microbes and their sensitivity pattern in each NICU and the antibiotic protocols should be periodically reviewed. Rational use of antibiotics and preventive measures like hand washing is the need of the hour.


Antibiotic, Blood culture, Neonatal septicemia, Organism

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Ferrieri P, Wallen LD. Newborn Sepsis and Meningitis. In: Gleason CA, Juul SE, eds. Avery’s Diseases of the Newborn. 10th ed. Philadelphia, PA: Elsivier; 2018: 553-565.

Singh M. Perinatal infections. In: Singh M, ed. Care of the Newborn. Revised 8th ed.: New Delhi: CBS publishers and distributors PVT. Ltd; 2017:285-294.

Haslam DB. Epidemiology of Infections. In: Kliegman RM, ST Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsivier; 2019:4249-4275.

Puopolo KM. Bacterial and Fungal infections. In: Cloherty JP, Eichenwald EC, Hansen AR, Stark AR, eds. Manual of Neonatal Care. 7th ed. Philadelphia, PA: Lippincot; 2012: 624-647.

Jyothi P, Basavaraj MC, Basavaraj PV. Bacteriological profile and antibiotic susceptibility pattern of the isolates. J Nat Sci Biol Med. 2013 Jul-Dec;4(2):306-9.

Jain NK, Jain VM, Maheshwari S. Clinical profile of neonatal sepsis. Kathmandu University Med J. 2003;1:117-20.

Thakur S, Thakur K, Sood A, Chaudhary S. Bacteriological profile and antibiotic sensitivity pattern of neonatal septicaemia in a rural tertiary care hospital in North India. Indian J Med Microbiol. 2016;34(1):67-71.

Gerdes JS. Diagnosis and management of bacterial infections in the neonate. Pediatric Clinics. 2004 Aug 1;51(4):939-59.

Kemeze S, Moudze B, Chiabi A, Eposse C, Kaya A, Mbangue M, et al. Clinical and bacteriological profile of neonatal bacterial infection at Laquintinie Hospital, Douala (Cameroon). Pan Afr Med J. 2016 Mar 15;23:97.

Kuruvilla KA, Thomas N, Jesudasan MV, Jana AK. Neonatal group B streptococcal bacteremia in India; ten year experience. Acta Paediatr. 1999;88(9):1031-2.

Shitaye D, Asrat D, Woldeamanuel Y, Worku B. Risk factors and etiology of neonatal sepsis in Tikur Anbessa University Hospital, Ethiopia. Ethiop Med J. 2010 Jan;48(1):11-21.

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

Stoll BJ, Hansen NI, Sánchez PJ, Faix RG, Poindexter BB, Van Meurs KP, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Early onset neonatal sepsis: the burden of group B Streptococcal and E. coli disease continues. Pediatr. 2011;127(5):817-26.

Isaacs D. A ten year, multicentre study of coagulase negative staphylococcal infections in Australasian neonatal units. Archives of Disease in Childhood - Fetal and Neonatal Edition. 2003;88:F89-F93.

Lee NC, Chen SJ, Tang RB, Hwang Bt. Neonatal bacteremia in a neonatal intensive care unit: analysis of causative organisms and microbial susceptibility. J Chin Med Assoc. 2004 Jan; 67(1):15-20.

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 Jun 27;18(1):208.

Chacko B, Sohi I. Early Onset Neonatal Sepsis. Indian J Pediatr. 2005;72(1):23-6.