ABSTRACT
Background: Sepsis remains a leading cause of mortality and morbidity, especially during the first five days of life and in low and middle-income countries. The purpose of this study was to note the clinical features and analyze the relationship between the septic screen and blood culture positive sepsis in the neonatal unit.Methods: A one-year descriptive cross-sectional study was carried out at the NICU of a teaching hospital in India.Results: The incidence of clinically suspected septicemia was 19.3 per 1000 live births and the incidence of blood culture positive septicemia was 2.9 per 1000 live births among the inborn of the hospital. The most common clinical features were poor suck and lethargy in culture positive sepsis. The most common organisms causing sepsis were Coagulase negative staphylococci and Klebsiella. In the septic screen CRP was found to have a statistically significant association with blood culture positive sepsis. CRP also had the highest sensitivity and negative predictive value among the studied parameters.Conclusions: Incidence of blood culture positive sepsis was 2.9 per 1000 live births among the inborn of the hospital. The most common clinical features were poor suck and lethargy in culture positive sepsis. The most common organism isolated in neonatal sepsis in the NICU was Coagulase negative staphylococcus. In resource poor settings, CRP continues to be an important tool in diagnosis and treatment of neonatal sepsis.
ABSTRACT
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.