Clinico-microbiological study of neonatal sepsis.

Neonatal sepsis, a systemic infection manifesting in the first month of life is a leading cause of mortality in the newborn .Blood culture is the main stay in the diagnosis of neonatal sepsis. The present study focuses on the bacterial agents, the antibiogram and the clinical risk factors associated with neonatal sepsis. One hundred and ten neonates with clinical suspicion of neonatal sepsis were included in this study. Bacterial pathogens isolated in positive blood cultures were identified and the antibiotic susceptibility testing was performed. The risk factors were noted from the case records & statistical analysis was done using the Chi square test. Thirty six (32.72%) cultures were positive among 110 suspected cases of neonatal sepsis. 22(61.11%) cases presented with early onset sepsis and 14(38.89%) presented as late onset sepsis. The common bacteria isolated were Klebsiella spp., Escherichia coli & Staphylococcus aureus. Antibiotics effective against gram negative bacilli were cefaperazone/sulbactam and piperacillin/tazobactam. The rate of Methicillin resistant Staphylococcus aureus isolation was 57%. Gram negative bacilli predominate as agents of neonatal sepsis & antibiotic resistance among bacteria is on rise. Thus there is a need for continuous screening and surveillance for antibiotic resistance in NICU.

Drug susceptibility profiles of Mycobacterium tuberculosis isolates at Mangalore.

Background and Objectives: Tuberculosis (TB) remains one of the major causes of death from a single infectious agent worldwide. Its resurgence in 1990s is primarily due to co-infection with HIV and the emergence of multi-drug-resistant (MDR) strains. Our objectives in this study were demonstration and grading of acid-fast bacilli in smears from sputum specimens of clinically newly diagnosed pulmonary TB patients, isolation of the organism, speciation and drug susceptibility testing of Mycobacterium tuberculosis isolates to isoniazid (H), rifampicin (R), streptomycin (S), and ethambutol (E). Materials and Methods: Sputum specimens were collected from 150 patients. Smear examination was done after Ziehl-Neelsen staining. The specimens were cultured onto Lowenstein Jensen media after Petroff's method of concentration. The growth was identified as M. tuberculosis with standard tests. Sensitivity of 50 isolates of tubercle bacilli to anti-TB drugs H, R, S, E were determined by Resistance-Ratio method. Results: Out of 150 sputum specimens examined, 62(41.3%) were smear positive. Out of these 62,56 grew on culture. 50 isolates of M. tuberculosis were picked up for drug susceptibility testing. Total of 31 (62%) were resistant to S, 14(28%) to H, 9(18%) to R, 6(12%) were resistant to E and 2 strains (4%) were resistant to H and R. Conclusion: From the small cohort, incidence of primary MDR-TB was found to be 4% in this region, which is within the expected range.