Bacteriological Profile of Neonatal Sepsis in a Tertiary Level Hospital of Nepal

Gp Acharya,R Khanal,S Manandhar

doi:10.3126/jnps.v34i3.9183

Abstract

Introduction: Neonatal sepsis is one of the most common reasons for admission to neonatal units in developing countries. It is also a major cause of mortality in both developed and developing countries. This study was done to determine the bacterial profile causing neonatal sepsis and to assess their susceptibility pattern to various antimicrobial agents. Materials and Methods: A cross-sectional prospective study was conducted in Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal among 340 neonates suspected of neonatal sepsis. Blood culture was performed and organisms were identified with Gram staining and conventional biochemical methods. Antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI). Results: The prevalence rate of neonatal sepsis was 20.3%. Among 340 neonates, 52.17% were males and 47.82% were females. Gram positive cocci were the most predominant isolates (88.40%). Among Gram positive cocci Staphylococcus epidermidis was the most common isolates (72.46%) followed by Staphylococcus aureus (7.24%), Staphylococcus saprophyticus (4.34%) and Enterococcus fecalis (4.34%). Gram negative bacilli were found in 11.60% of the growth positive samples of which E.coli and Klebsiella spp were found in 10.14% and 1.44% respectively. Sensitivity to Amikacin was highest among all types of organisms isolated. Vancomycin and Gentamycin sensitivity was highest for Gram positive and Gram negative organisms respectively. Ampicillin resistance was highest among isolates. Among the 69 isolates 48 were Multiple drug resistant. Conclusion: The predominance of Gram positive cocci particularly Coagulase negative Staphylococci is shown. Empirical antibiotic therapy should be reviewed for Multiple drug resistant strains. DOI: http://dx.doi.org/10.3126/jnps.v34i3.9183 J Nepal Paediatr Soc 2014;34(3):175-180

Highlights

IntroductionNeonatal Sepsis (sepsis neonatorum) is a clinical syndrome resul ng from the pathophysiologic effects of local or systemic infec on in the first month of life
Neonatal sepsis is one of the most common reasons for admission to neonatal units in developing countries
Neonatal sepsis remains as an important cause of morbidity and mortality among infants in

Summary

Introduction

Neonatal Sepsis (sepsis neonatorum) is a clinical syndrome resul ng from the pathophysiologic effects of local or systemic infec on in the first month of life. The incidence of sepsis in neonatal period is 1-10 per 1000 live births with a mortality rate as high as 15-20% 2 It is roughly three mes more in developing countries like Nepal. In our country pre-exis ng data on both early and late onset sepsis has been shown great diversity in the changing pa erns of the organisms and their sensi vity pa erns. Based on this considera on, a study was carried out to inves gate the causa ve bacterial organisms of Neonatal sepsis and to assess their an bio c suscep bility pa ern in the Neonatal unit of Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu, Nepal

Materials and Methods

Results

Discussion

Conclusion