Neonatal Sepsis: Clinical Spectrum, Bacteriological Profile and Antibiotic Sensitivity Patterns in Neonatal Intensive Care Unit in a Tertiary Care Hospital

ABSTRACT

Introduction: Neonatologists face a perpetual challenge in managing neonatal septicaemia due to changing patterns of the microbial flora and their antibiotic sensitivity. The present study was designed to evaluate the clinical spectrum, bacteriological profile, antibiotic sensitivity patterns in neonates with suspected septicaemia in a tertiary care teaching hospital. Material and Methods: This prospective observational study was carried out in neonatal intensive care unit for a period of nine months. All the neonates with suspected septicaemia, were evaluated by sepsis screen (C- reactive protein). C-reactive protein positive neonates were subjected to blood culture for isolation of microorganisms. Antibiotic sensitivity testing was done with disc diffusion method. The data was analyzed using descriptive statistics. Results: Among 519 neonates, blood culture was positive in 183 (35.2%). Most of the neonates presented with early onset sepsis(65%), were preterm(59%) and of low birth weight (58.5%). Major clinical presentation was respiratory distress (31.2%). Gram negative bacteria were frequently isolated (68.3%). Most common isolates were Klebsiella pneumonia (34.70%) and staphylococcus aureus (21.8%) respectively. Gram negative organisms were sensitive to imipenem, followed by piperacillin tazobactam and amikacin. Gram positive organisms showed good sensitivity to vancomycin, teicoplanin and imipenem. High resistance was observed to ampicillin and ceftriaxone in both gram positive and gram negative organisms. Conclusions: Preterm and low birth weight neonates were more susceptible to neonatal sepsis. Gram negative organisms were frequently isolated. The present study would suggest rational use of empirical antibiotic therapy and to review the antibiotic policy periodically basing on the microbial flora detected in their region time to time.