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.

Early Onset and Late Onset of Neonatal Sepsis in a Tertiary Hospital, South-South, Nigeria

“…Respiratory distress syndrome was the major clinical features amongst other features with 36.0% in this study which is similar to recent studies by Kurma et al [30] with 31.2%, Khante et al [37] with 34.15% and 56% for study by Sathyamurthi et al [38]. This indicates that, this clinical feature has been one of the greatest problems to neonates till date.…”

“…This study has demonstrated the continued role of septicemia in pediatric morbidity and mortality in this environment. In this study, it was observed that early-onset neonatal septicemia was more common than late-onset neonatal septicemia, this is similar to reports of Chako and Sohi in [26], Rasul et al [27], West and Tabansi in [28], Peterside et al [29], and Kurma, et al [30] in which early-onset septicemia generally was more common.…”

“…Gram-negative bacteria accounted for 66.2% of all isolates and were more recorded in earlyonset of neonatal septicemia while Gram-positive bacteria had 33.8%. Elsewhere with similar studies, had the same report in Abeokuta and Enugu, Nigeria and India [43,34,30]. This recent studies have re-affirmed the role played by Gram-negative bacteria in this study.…”

“…This recent studies have re-affirmed the role played by Gram-negative bacteria in this study. In contrast, Gram-positive organisms were reported in studies conducted in Ilorin, Bauchi and Bayelsa in Nigeria [30,44,28] and in India [39,41].…”

“…The reported incidence of neonatal sepsis varies from place to place; 7.1% to 38% by per 1000 live births in Asia [35,36] and 35.2% in India [30].…”