Abstract
ObjectiveNeonatal sepsis is a major cause of morbidity and mortality of newborns (< 1 month of age). Septicemia and drug resistance is a predominant issue for neonatal death in Nepal. This study is intended to find bacteriological profile of neonatal sepsis and antibiotic susceptibility pattern of the isolates from neonates at Kanti Children’s Hospital, Kathmandu, Nepal.ResultsOut of 350 suspected cases of neonatal sepsis, 59 (16.9%) cases showed positive blood culture. The prevalent of positive blood culture with different neonatal risk factors (sex, age, birth weight, gestational age, and delivery mode) showed highest positive bacterial growth in male (52.3%); 3 or above 3 days age (71.2%); low birth weight (62.7%); preterm gestational age (31.4%); and caesarean delivery mode (63.3%). Among positive cases, the bacteriological profile was found highest for Staphylococcus aureus (35.6%) followed by Klebsiella pneumoniae (15.3%). The most sensitive and resistive antibiotics among Gram-positive isolates were gentamicin (93%) and ampicillin (78%), respectively. Meropenem and imipenem showed highest 100% effective and cefotaxime was least (28%) sensitive among Gram-negative isolates. This concludes broad ranges of bacteria are associated with neonatal sepsis and revealed variation in antibiotic susceptibility pattern among bacterial isolates.
Highlights
Neonatal sepsis is a clinical syndrome resulting from the pathophysiologic effects of local or systemic infection
This study aims to determine incidence and bacteriological profile of neonatal sepsis in relation to neonatal risk factors along with antibiotic susceptibility pattern of the isolates from neonates admitted in neonatal intensive care unit of Kanti Children’s Hospital, Kathmandu, Nepal
In relation to different neonatal risk factors, positive blood culture showed the highest prevalence of bacterial growth in neonatal cases with 3 or above 3 days age (71.2%); low birth weight (62.7%); preterm gestational age (31.4%); and caesarean mode of delivery (63.3%)
Summary
Neonatal sepsis is a clinical syndrome (sepsis neonatorum) resulting from the pathophysiologic effects of local or systemic infection. It affects newborns below 1 month of age and encompasses systemic infections including meningitis, pneumonia, arthritis, osteomyelitis and urinary tract infections [1, 2]. Neonates are immunecompromised and defend weakly to bacterial infections. The bacterial agents associated with neonatal sepsis are. Unsafe birthing practices have critical role to cause neonatal infections. The neonatal morbidity and mortality cases have been estimated to 2.5–3 million, annually [6]. Neonatal mortality rate (NMR) distribution disparities can be seen based on socioeconomic, educational and geographical parameters. In Nepal, neonatal mortality has been found due to septicemia and emergence of drug resistant bacteria.
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