BACTERIOLOGICAL PROFILE OF NEONATAL SEPSIS IN NEONATAL INTENSIVE CARE UNIT (NICU) IN A TERTIARY CARE HOSPITAL: PREVALENT BUGS AND THEIR SUSCEPTIBILITY PATTERNS

*Hura Kanwaljeet Singh, MD, Phuljhele Sharja, MD and Khandwal Onkar, MD

ABSTRACT

Introduction: Neonatal sepsis remains an important cause of neonatal morbidity & mortality in NICU setup and a major challenge for the neonatologists. The prevalent organisms & their antibiotic resistance patterns evolve with time and with the usage of antimicrobials. Knowledge of the causative bacteria & their antibiotic resistance patterns is pivotal for better therapeutic results. Aims & Objectives: To analyze the bacteriological profile and antibiotic resistance patterns of proven neonatal sepsis cases in NICU setup of a tertiary care Hospital. Materials and Methods: The study is Prospective obervational study. The study Conducted at Pt. Jawahar Lal Nehru Memorial (JNM) Medical College and Hospital, Raipur, Chhattisgarh, India. The Duration of study was from January 2013 to December 2013 (12 months). All proven neonatal sepsis cases in NICU with positive blood culture reports (141 cases) were included in the study. Clinically suspected cases of neonatal sepsis admitted to NICU were further evaluated with blood cultures & antibiotic susceptibility testing using the Kirby Bauer disc diffusion method. Data was collected for the following variables: Demographic profile, gestational age, age of onset of sepsis (early versus late), culture results & antibiotic resistance patterns. Results: Out of 841 cases of clinically suspected neonatal sepsis, 141 were culture positive. Klebsiella pneumoniae was the most common isolate accounting for 49.64% cases followed by Escherichia coli 26.95%, Pseudomonas aeruginosa 7.80%, and Staphylococcus aureus 7.09%. High level of resistance was found against various antibiotics such as ampicillin(58-63%),Third generation cephalosporins(9-41%) and combination drugs such as piperacillin-tazobactum(7.8-32.8%). Meropenem is most sensitive antibiotics. Conclusion: Gram negative bacteria were the most common cause of neonatal sepsis. Increased level of resistance was found to penicillins, 3rd generation cephalosporins & piperacillin-tazobactum in the present study thus suggesting judicious use of these antibiotics in NICU setup.

Keywords: Neonatal sepsis, Bacterial isolates, antibiotic sensitivity, NICU.