Bacteriological Profile And Antibiotic Susceptibility Pattern Of The Isolates Among The Neonatal Septicemia In Northeast India

ABSTRACT

Background: Bacterial resistance to antibiotics was a global problem. Multidrug-resistant bacteria causing neonatal septicemiaswere increasing in the world. It was difficult to compare the bacterial profile and antibiotic susceptibility pattern of the isolatesamong the neonatal septicemia between countries because the epidemiology of neonatal septicemia was extremely variable.Objective: Timely identification of bacterial profile and antibiotic susceptibility pattern of the isolates among the neonatalsepticemias are essential to guide the clinicians regarding both the empirical and definitive treatments of neonatal septicemia.Materials and Methods: Based on the AIIMS protocol 2014 of neonatal sepsis-World Health Organization newborn CC,an operational definition of clinically diagnosed neonatal septicemia was established for the selection of participants inthe study for blood culture and sensitivity test (CST). Hence, in this study, blood CST was done only among the selectedpatients for clinically diagnosed neonatal septicemia as recommended in the National Committee for Clinical LaboratoryStandards.Results: This study observed that there was a shift from the predominance of Gram-negative organisms to Gram-positiveorganisms, especially Staphylococcus aureus. Acinetobacter and Citrobacter were emerging organisms.In this study,aminoglycosides and fluoroquinolones were sensitive to organisms, especially in Gram-negative organisms. Imipenem andmeropenem were also sensitive in both Gram-positive and Gram-negative organisms. Imipenem was more sensitive toorganisms than meropenem. Tobramycin, doxycycline, gatifloxacin, and chloramphenicol were more sensitive to organismsthan erythromycin, azithromycin, and clindamycin.Conclusion: Early clinical diagnosis and prompt initiation of empirical antimicrobials therapy to patients of pending culturesensitivity reports for definitive therapy may be life-saving. Hence, periodic surveillance for bacteriological profile and antibioticsusceptibility pattern of the isolates among the neonatal septicemia for appropriate choice of antimicrobials for empirical therapycan be outlined and reevaluated in a timely manner to save the life of 5 million neonatal deaths a year, with 98% occurringin developing countries and limited resource rural areas. This study concluded that empiric therapy for clinically diagnosedneonatal septicemia should cover both Gram-negative and Gram-positive organisms. Hence, the combination of one antibioticfrom each of the following two groups, (1) Imipenam/piperacillin/cefotaxime and (2) amikacin/gentamicin/netilmicin, can beincluded as an initial therapy for neonatal septicemia.