Spectrum And Antimicrobial Susceptibility Pattern Of Isolates In Neonatal Sepsis
Keywords:
Blood culture, Neonatal sepsis, Gran negative, antimicrobial stewardshipAbstract
Introduction: Neonatal sepsis is a significant cause of morbidity and mortality, particularly in developing countries. Identifying causative pathogens and their antimicrobial resistance patterns is critical for effective management. This study aimed to assess microbial diversity, antimicrobial resistance, and recommend effective treatment strategies for neonatal sepsis at a tertiary care hospital.
Material & Methods: This study was carried out at the Department of Microbiology, National Institute of Medical Sciences and Research. A total of 120 neonates with suspected sepsis were included. Blood cultures were performed using the BacT/ALERT system, and antimicrobial susceptibility testing followed CLSI guidelines.
Results: Of 120 neonates, 59 (49.2%) had EOS and 61 (50.8%) had LOS. Blood culture positivity was 44/120 (36.7%). The most common isolates were Klebsiella pneumoniae (31.8%), Pseudomonas aeruginosa (11.4%), and Staphylococcus aureus (4.5%). Gram-negative isolates showed 100% resistance to ceftriaxone and cefotaxime, 82.1% to imipenem, and 75.0% to meropenem. Colistin (100% sensitivity, p < 0.001) and tigecycline (95.7%, p = 0.002) were the most effective agents.
Conclusion: The study highlights a high prevalence of Gram-negative bacterial infections and rising antimicrobial resistance in neonatal sepsis. Based on resistance patterns, colistin, tigecycline, and minocycline should be considered for multidrug-resistant infections, while glycopeptides (vancomycin, teicoplanin) remain effective for Gram-positive infections. The findings emphasize the need for routine surveillance, antimicrobial stewardship, and judicious antibiotic use to optimize neonatal sepsis treatment
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Ratzinger F, Schuardt M, Eichbichler K, et al. utility of Sepsis Biomarkers and the Infection probability Score to Discriminate Sepsis and Systemic Inflammatory Response Syndrome in Standard Care Patients. PLoSoNE. 2013;8(12):e82946
Bang AT, Bang RA, Bactule SB, Reddy HM, Deshmukh MD. Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. Lancet 1999; 354:1955-61
Kenzel S, Henneke L. The innate immune system and its relevance to neonatal sepsis.CurrOpin Infect Dis. 2006; 19(3):264-70.
MathurB.Neonatal sepsis.Indianpediatr.1996;33:633-74.
Collee JG, Marr W. Culture of bacteria. In Collee JG, Fraser AG, Marmion BP, Simmons A. eds. Mackie and McCartney Practical Medical Microbiology. 14th ed. Churchill Livingstone. New York. 1996:121-124.
Haque KN. Definitions of bloodstream infection in the newborn. Pediatr Crit Care Med. 2005;6(3 Suppl):S45-49
Stoll BJ, Hansen NI, Adams-Chapman I, Fanaroff AA, Hintz SR, Vohr B, et al. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection. JAMA. 2004;292(19):2357-2365.
Fanaroff AA, Korones SB, Wright LL, Verter J, Poland RL, Bauer CR, et al. Incidence, presenting features, risk factors and significance of late onset septicemia in very low birth weight infants. The National Institute of Child Health and Human Development Neonatal Research Network. Pediatr Infect Dis J. 1998;17(7):593-598.
Liljedahl M, Bodin L, Schollin J. Coagulase-negative staphylococcal sepsis as a predictor of bronchopulmonary dysplasia. Acta Paediatrica. 2004;93(2):211-215
Payne NR, Carpenter JH, Badger GJ, Horbar JD, Rogowski J. Marginal increase in cost and excess length of stay associated with nosocomial bloodstream infections in surviving very low birth weight infants. Pediatrics. 2004;114(2):348-355.
Chen YY, Chou YC, Chou P. Impact of nosocomial infection on cost of illness and length of stay in intensive care units. Infect Control Hosp Epidemiol. 2005;26(3):281-287 15.
Gupta L.K, Dayal R, Yadav M.B, Kumar N, Singh M. Current Scenario of Neonatal Sepsis in West U.P. Int J Pediatr Res. 2018;5(12):609-616.doi:10.17511/ijpr.2018.i12.02.
Iroha EO, Egri-Okwaji MTC, Kesah CN et al. Changing patterns of causative organisms of neonatal septicaemia at Lagos University Teaching Hospital. Nig J Paediatr 1998; 25: 1–5.
Shobowale EO, Ogunsola FT, Oduyebo OO et al. Aetiology and risk factors for neonatal sepsis at the Lagos University teaching hospital, Idi-Araba, Lagos, Nigeria. S Afr J Child Health 2016; 10: 147–50.
Kaistha N, Mehta M, Singla N, Garg R, Chander J. Neonatal septicemia isolates and resistance patterns in a tertiary care hospital of North India. J Infect Dev Ctries. 2009;4:55–7
Zakariya BP, Bhat V, Harish BN, Arun Babu T, Joseph NM. Neonatal sepsis in a tertiary care hospital in South India: bacteriological profile and antibiotic sensitivity pattern. The Indian Journal of Pediatrics. 2011;78:413-7.
Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, Lemons JA, Donovan EF, Stark AR, Tyson JE, Oh W. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network.Pediatrics. 2002;110 (2):285-91.
Obadare T, Adejuyigbe E, Adeyemo A et al. Characterization of neonatal sepsis in a tertiary hospital in Nigeria. Int J Infect Dis 2022; 116: S18.
Tumuhamye J, Sommerfelt H, Bwanga F et al. Neonatal sepsis at Mulago National referral hospital in Uganda: etiology, antimicrobial resistance, associated factors and case fatality risk. PLoS One 2020; 15: e0237085.
Hegadi S, Jitendranath A. Evaluation of risk factors and bacteriological profile of neonatal sepsis among patients admitted at Navodaya Medical College, Hospital and Research Center, Raichur. Indian J Microbiol Res 2017; 4: 298–304
Iregbu KC, Elegba OY, Babaniyi IB. Bacteriological profile of neonatal septicaemia in a tertiary hospital in Nigeria. Afr Health Sci. 2006;6:151–4
Siddiqui T, Dubey A, Kar M, Patel SS, Sahu C, Ghoshal U. Bacteriological profiles and antibiotic susceptibility of neonatal sepsis in a university hospital of Northern India. J Family Med Prim Care 2023;12:493-8
Jatsho J, Nishizawa Y, Pelzom D, Sharma R. Clinical and Bacteriological Profile of Neonatal Sepsis: A Prospective Hospital‐Based Study. International journal of pediatrics. 2020;2020(1):1835945.
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