Bacteriological spectrum and antimicrobial susceptibility pattern of neonatal septicaemia in a tertiary care hospital of North India

Abstract

Background: Neonatal septicaemia is a clinical entity that is characterised by systemic signs and symptoms of infection and accompanied by bacteraemia in first 4 weeks of life and is one of the four leading causes of neonatal mortality and morbidity in India.

Aim: To determine the bacterial spectrum and antimicrobial susceptibility pattern of neonatal septicaemia in a tertiary care hospital of North India.

Materials and methods: In this prospective observational study, 850 blood samples were collected and processed from clinically suspected neonates according to standard laboratory protocol. Antimicrobial susceptibility of the isolates was done by Kirby Bauer disc diffusion method according to Clinical and Laboratory Standard Institution (CLSI) recommendations.

Results: Blood culture reports were positive in 322 (37.8%) cases. Early onset sepsis (EOS) was present in 61.41% and late onset sepsis (LOS) in 38.59% of cases. Gram-negative septicaemia (60.67%) was encountered more than Gram-positive (32.01%). Coagulase negative Staphylococci (17.43%) was the predominant isolate followed by, Klebsiella spp in 16.11% cases. Best overall sensitivity among Gram-negative isolates was to Colistin (89.94%), Imipenem (86.43%) and Meropenam (77.88%). Gram-positive isolates had good (97.15%) sensitivity to linezolid, (95.23%) vancomycin and (88.57%) Teicoplanin.

Conclusion: Gram-negative organisms are the leading cause of neonatal septicaemia with Klebsiella spp being commonest. Coagulase negative Staphylococci is the predominant isolate among Gram-positive organisms. Most of the isolates are resistant to common antibiotics.

Keywords:

• Antimicrobial susceptibility
• blood culture
• changing bacterial spectrum
• neonatal septicaemia

Declaration of interest

The authors have no conflicts of interest and no financial relationships relevant to this article to disclose. No external funding was secured for this study.