Bacteriological Profile of Neonatal septicemia in tertiary care NICU in India

Abstract

Back ground: Sepsis is the commonest cause of neonatal mortality; it is responsible for about 30-50% of the total neonatal deaths in developing countries. It is estimated that up to 20% of neonates develop sepsis and approximately 1% die of sepsis related causes. Sepsis related mortality is largely preventable with rational antimicrobial therapy and aggressive supportive care. Objectives: To isolate and identify the aerobic bacterial pathogens causing both early and late onset septicemia .To evaluate the antimicrobial susceptibility pattern of aerobic bacterial organisms isolated from neonatal septicemia. Material and methods: This prospective study was conducted on 100 neonates with signs and symptoms of septicemia admitted in neonatal intensive care unit, Malla Reddy Medical College for Women Suraram, Hyderabad over a period of one year from January 2013 to December 2014. Results: Blood culture positivity was 35 %. Early onset sepsis 28 (57%) was more common than late onset septicemia 28 (43%). Out of total isolates Gram positive organisms constituted 20 (62.5%). In gram positive organisms coagulase negative staphylococci and Staphylococcus aureus were commonest organisms 9 (45%). Gram negative organisms constituted 15 (37.5%) out of 35 total bacterial isolates. In 15 gram negative isolates klebsiella pneumonia was commonest isolate 8 (52%), followed by Escherichia coli 3 (20%), Pseudomonas auriginosa 3 (20%) and Acinetobacter 1 (8%) Conclusion: The present study suggests that there is a increase in incidence of ESBL producers among Gram Negative pathogens i.e. Klebsiella pneumonia, Escherichia coli, Pseudomonas, Acinetobacter in neonatal septicemia of both Early and late onset and many of them are resistant to commonly used third generation cephalosporin i.e. cefotaxim, ceftriaxone, ceftazidime.