Neonatal Sepsis: The Alarm Bell is Ringing Loud!

ABSTRACT

Introduction: Neonatal sepsis remains an important causeof neonatal mortality and morbidity despite the tremendousadvances in the field of neonatology over the last two decades.Current research aimed to study the profile of neonatal sepsis& its antimicrobial sensitivity pattern.Material and methods Two year prospective observationalstudy was conducted at NICU of NMCH Patna from May2018 to April 2020. Neonates with clinical diagnosis ofneonatal sepsis as per IMCI and WHO clinical criteria forneonatal sepsis and/or >2 risk factors associated with EONSwere enrolled in study.Results: Out of the 341 cases enrolled, blood culture waspositive in only 130(38%). Incidence of EONS was 67%and that of LONS was 33%. Majory of the septic neonateswere preterm (64%). 55% of such neonates were of malesex. Gram negative bacteria accounted for 55% of all cases,61% of EONS and 44% of LONS cases. The most commonisolate was Staph. aureus closely followed by Klebsiella sp.Gram negative bacteria, esp. Klebsiella had a high incidenceof resistance to the empirical antibiotic used and to most ofthe commonly used antibiotics. Culture positive group had asignificantly higher mortality as compared to culture negativegroup(p<0.001).Conclusion: Blood culture though gold standard was notpositive in majority of the cases. Neonatal sepsis was morecommonly associated with prematurity. Gram negativeorganisms were the commonest etiologic agents. Emergenceof strains resistant to even the newest antibiotics poses a greatconcern.