Background: Neonatal sepsis is a leading cause of
neonatal mortality and
morbidity . The objective of the study was to detect causative microorganisms of
neonatal sepsis and their antimicrobial resistance patterns.
Methods: This prospective
cross-sectional study was conducted from July 2017 to June 2018 in the Department of Neonatal
Medicine and NICU of Dhaka Shishu (
Children )
Hospital (DSH).
Neonates diagnosed with probable
sepsis were studied. After enrollment, 1 mL
blood was taken and sent to
Microbiology department of DSH for
culture and
sensitivity . With baseline characteristics, clinical examination findings and outcome, were also recorded.
Results: Rate of isolation of single organism was 9.2% (84/913). Out of 84 isolates,
gram negative bacteria were 77.4% with
Klebsiella pneumonae being the commonest (35, 41.7%),
gram positive bacteria were 11.9% with
Staphylococcus aureus and
Streptococcus were equal (5, 5.95% each) and the remaining (9, 10.7%) isolated organism was
Candida . Most of the isolated
gram-negative bacteria were resistant to
ampicillin ,
gentamicin , and
ceftazidime ; but
gram-positive bacteria preserved 20-80%
sensitivity .
Klebsiella was more resistant than
Acinetobacter to
amikacin ,
netilmicin ,
ciprofloxacin and
levofloxacin . Around 45-65% of
gram-negative bacteria were resistant to
imipenem and
meropenem but
gram-positive bacteria showed lesser resistance. Among the
gram-negative bacteria ,
Klebsiella and
Acinetobacter were resistant to
piperacillin as same as
carbapenem group, but
gram-positive bacteria were 100% sensitive to
piperacillin . All the
gram-negative bacteria showed more resistance to 4th generation
cephalosporin ,
cefepime than
carbapenem . Out of
culture positive 84
neonates , 63 (75.0%) were cured but 21 (25.0%) died. Among the 21 expired
neonates , 47.6% (10/21) were infected with
Klebsiella .
Conclusion: This study observed that
gram-negative bacteria causing
neonatal sepsis predominantly, with emergence of
Candida . All the isolated gram-positive and gram-negative organisms were mostly resistant to available
antibiotics