Bacteriological Profile and Outcome of Culture-Positive Neonatal Sepsis in a Special Newborn Care Unit Setting, Odisha

Abstract

Introduction: Nearly one-third of neonatal mortality in India is due to neonatal sepsis and death occurs in 30% of culture-positive neonates. Pathogens such as Klebsiella pneumoniae and Escherichia coli are the most common bacteria responsible for neonatal sepsis in India and South Asia. Materials and Methods: It was an observational study, conducted in special newborn care units (SNCUs) of Capital Hospital in Bhubaneswar, Odisha from May 2017 to October 2019. All neonates (<28 days of life) with blood culture-positive sepsis were included in this study. Blood cultures were sent in all the babies with features of clinical sepsis. The demographic profile of neonates, clinical presentations, isolated organisms, and their sensitive patterns was recorded for analysis. Results: Blood culture was sent in 445 suspected neonates with clinical sepsis out of which 115 blood culture positive organisms were isolated. Among the isolated organisms, 42 (35.6%) cases were Staphylococcus aureus followed by Coagulase negative Staphylococcus (CONS) (20.8%), E. coli (19.1%), K. pneumoniae (10.4%), Acinetobacter baumannii (2.7%), Enterobacter spp.(4.3%), Enterococcus spp. (4.3%), and Pseudomonas aeruginosa (2.7%). S. aureus was the predominant organism found in both early and late-onset sepsis. All Gram-negative bacilli (GNB) are resistant to ampicillin whereas cephalosporin resistance was found in 68% of cases. Mortality due to sepsis was 8%. Conclusion: S. aureus followed by CONS was found to be the most common cause of sepsis in SNCU. A high degree of resistance of organisms to penicillins and cephalosporins calls for a re-evaluation of antibiotic policy and protocols for empirical treatment in neonatal sepsis.

Risk factors and etiology of early-onset neonatal sepsis in Northeastern part of India: Case–control study

“…In a previous Indian study, Staphylococcus aureus and Klebsiella emerged as the most common organisms for EONS. [ 23 24 ]…”

“…conducted in India showed good sensitivity to aminoglycoside and vancomycin and low resistance to cephalosporins. [ 23 24 ]…”

Bacteriological Profile and Antibiogram Pattern in Isolates From Neonatal Sepsis in a Tertiary Care Hospital

“…LOS is caused by postnatal acquisition of the pathogens, caused by the bacteria which thrive in the external environment of the hospital or home. There is a gradually increasing trend of multi-drug resistant (MDR) pathogens in tertiary care neonatal intensive care units (NICU) and special newborn care units (SNCUs) all over India [3]. Multi-drug resistance was defined as the acquired resistance to at least one agent in three or more antimicrobial categories as per the Centers for Disease Control and Prevention (CDC) guidelines [4].…”

“…Multi-drug resistance was defined as the acquired resistance to at least one agent in three or more antimicrobial categories as per the Centers for Disease Control and Prevention (CDC) guidelines [4]. Strict antibiotics stewardship program will enable us to counteract multidrug resistance patterns of emerging pathogens [3].…”

The changing bacteriological profile of neonatal sepsis in a tertiary care hospital – Emergence of Citrobacter septicemia

“…[3][4][5] Based on the onset of illness, Neonatal sepsis is classified as early onset sepsis (EOS) (<72 h), occurs due to pathogens present in the genital tract of the mother and other one is late onset sepsis (LOS) (>72 h), occurs due to pathogens acquired either from the hospital or from the community. 3 All over India, there is a gradually increasing trend of multi-drug resistant (MDR) pathogens in neonatal intensive care units (NICU) and special newborn care units (SNCUs) in tertiary care hospitals. As per the Centers for Disease Control and Prevention (CDC) guidelines Multi-drug resistance was defined as the acquired resistance to at least one agent in three or more antimicrobial categories.…”