Abstract
Background: Neonatal septicemia signifies a generalized bacterial infection documented by a positive blood culture and is one of the leading causes of neonatal mortality and morbidity in India.
Aim: To isolate and identify the bacterial etiological agents responsible for neonatal sepsis and to determine their susceptibility pattern in a tertiary care hospital.
Materials and Methods: 108 blood culture positive neonatal cases admitted from 1st December 2016 to 1st December 2017 were included in the study.
Results: Out of a total of 108 blood culture positive cases, the majority were Gm negative bacteria comprising 75 (69.44%), Gm positive bacteria comprised 31(28.7%) and 2(1.85%) were positive for fungal organisms (Candida other than C.albicans). Among the Gm negative organisms, most common were Enterobacter spp. comprising 44(40.74%) [Enterobacter cloacae forming 23(21.30%) and Enterobacter aerogenes forming 21(19.44%)], followed by Acinatobacter 13(12.04%), Klebsiella spp. 7(6.48%), Pseudomonas aeruginosa 6(5.56%), E.coli 2(1.85%), Burkholderia capacia 2(1.85%) and Citrobacter 1(0.93%). Among Gm positive organisms, most common was Coagulase negative Staphylococcus forming 24(22.22%) followed by Enterococcus 4(3.7%), Streptococci 2(1.85%) and Coagulase positive Staphylococcus 1(0.93%).
Conclusion: Gm negative organisms are the leading cause of neonatal sepsis in our study with most being resistant to multiple antibiotics. Enterobacter septicemia is a cause of concern with its rising incidence. A regular antibiotic surveillance is a necessity in every hospital to reduce antibiotic resistance.
Keywords: Neonatal septicemia, susceptibility, surveillance, resistance.
References
- Misallati A, El-Bargathy S, Shembash N. Blood culture proven neonatal septicemia : a review of 36 cases. Eastern Mediterranean Health Journal 2000;6:483-86.
- Bode-Thomas F, Ikeh EI , Pam SD, Ejellogn EU. Current aetiology of neonatal sepsis in Jos University Teaching Hospital. Niger J Med 2004; 13: 130-35.
- Mathur M, Shah H, Dixit K, Khambadkone S, Chakrapani A, Irani S. Bacteriological profile of neonatal septicemia cases [for the year 1990-91]. J Postgrad Med 1994; 40: 18-20.
- Mahapatra A, Ghosh SK, Mishra S, Pattnaik D, Pattnaik K, Mohanty SK. Enterobacter cloacae : a predominant pathogen in neonatal septicemia. Indian J Med Microbiol 2002; 20: 110-12.
- Namshad Uddin Ahmed ASM, Azad Chowdhary, MAK, Hoque M, Garmstadt GL. Clinical and bacteriological profile of neonatal septicemia in a tertiary level pediatric hospital in Bangladesh. Indian Pediatrics 2002; 39: 1034-39.
- Mokuolo AO, Jiya N, Adasiyam OO. Neonatal septicemia in Ilorin. Bacterial pathogens and antibiotic sensitivity pattern. Afr J Med Sci 2002; 31: 127-30.
- Collee, J.G, Fraser, A.G, Marmion, BP and Simmons, A.(ed.) (1996): Mackie and McCartney Practical Medical Micribiology. p 113-29. 14th Churchill Livingstone, Edinburgh.
- Collee JG, Hayward NJ, Marr W. Blood culture. In: Cruickshank K, Duguid JP, Marmion BP, Swain RHA, editors. Medical Microbiology, Vol 2. 12th Edinburgh : Livingstone, 1975 : 162-4.
- Performance standards for Antimicrobial Susceptibility Testing. Eighth information Supplement 2000. National Committee for Clinical laboratory Standards (NCCLS) M2A7 Vol 20, No. 1 and 2 Villanova. Pa.
- 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.
- Ullah O, Khan A, Ambreen A, Ahmed I, Akhtar T, Gandapor AJ, Khan AM. Antibiotic sensitivity pattern of bacterial isolates of Neonatal Septicemia in Peshawar, Pakisthan. Arch Iran Med. 2016; 19 (12): 866-69.
- Kumhar GD, Ramachandran VG, Gupta P. Bacteriological analysis of blood culture isolates from neonates in a tertiary care hospital in India. J Health Popul Nutr 2002; 20: 343-47.
- Agnihotri N, Kaistha N, Gupta V. Antimicrobial susceptibility of isolates from neonatal septicemia. Jpn J Infect Dis 2004; 57
- Jyothi P, Metri C, Basavaraj and Peerapu V.Basavaraj. Bacteriological profile of neonatal septicemia and antibiotic susceptibility pattern of the isolates. J Nat Sci Biol Med. 2013. Jul-Dec; 4(2): 306-09.
- Waheed M, Laeeq A, Maqbool S. The etiology of neonatal sepsis and patterns of antibiotic resistance. JCPSP. 2003; 13(8): 449-52.
- Poonam Marwah, Deepak Chawla, Jagdish Chander, Vishal Guglani and Ashish Marwah. Bacteriological profile of neonatal sepsis in a tertiary care hospital of northern India. Indian Ped. Vol 52-158-9.
Corresponding Author
Dr (Mrs.) Rinku Saini
Assistant Professor, Department of Pediatric Medicine, SMS Medical College, Jaipur, Rajasthan, India