Bacteriological profile and antibiotic susceptibility pattern of neonatal septicemia in a tertiary care hospital of Tripura

Abstract

Background:Sepsis is the commonest cause of neonatal mortality and is influenced by the quality of intrauterine life, host and environmental factors. The present study was undertaken to identify the aetiological agents causing neonatal septicemia and analyze the antibiotic susceptibility pattern, so as to guide the Pediatrician in formulating an empirical antibiotic policy against the predominant pathogens in this geographical area of North East India. Methods:On clinical suspicion of septicemia, atleast two sets of test for blood culture were performed and such neonates included in the study. Antimicrobial Susceptibility Testing was subsequently performed following Kirby Bauer Disc Diffusion method. The data obtained from culture proven septicemia was analyzed. Results:Blood culture was positive in 41.1% clinically suspected cases of septicemia. Early Onset Septicemia was confirmed in 73(57.5%) and Late Onset Septicemia in 54(42.5%) neonates. The Gram Positive organisms (51.1%) predominated over Gram negative organisms (48.9%). Staphylococcus aureus (34.6%) was the most predominant isolate followed by Klebsiellapneumoniae (24.4%). The antibiotic sensitivity pattern of the gram positive blood culture isolates indicates that all isolates were sensitive to Vancomycin. The Cephalosporins, Clindamycin and Amikacin were found significantly sensitive to Staphylococcus aureus(95.5%). All Gram negative isolates were sensitive to Imipenem followed by Piperacillin-tazobactum and Amikacin. Conclusion:Amikacin along with a third generation Cephalosporin like Cefotaxime were chosen to be the first line regimen for treatment of cases of septicemia in our setting. The predominant isolate of Staphylococcus aureus along with significant association of maternal risk factors indicates the possibility of cross infection in NICU from index case, for which emphasis need to be laid on Hospital infection control strategies. Keywords: Neonatal septicemia, Aetiology, Risk fact