Drug-resistant organism in early-onset and late-onset neonatal sepsis at tertiary care hospital

Abstract

Context: Neonatal sepsis is one of the common reasons for admission to neonatal units in developing countries. Resistance to antibiotics is increasing in neonatal sepsis. Aims: To evaluate the antibiotic resistant pattern of pathogens associated with early-onset and late-onset neonatal sepsis. Settings and Design: This cross-sectional study was done at special care baby unit of a tertiary care hospital from January 2008 to June 2009. Subjects and Methods: All neonates with risk factors or clinical features of sepsis were enrolled and samples for blood cultures were taken. Neonates whose blood culture yielded growth of bacteria were included in this study. Standard data collection form was used to collect all demographic data, pathogen, and resistant to antibiotics. Statistical Analysis Used: Chi-square test and Fisher's exact test were used for compare the variables. The value P< 0.05 was considered statistically significant. Statistical analysis was done using EpiInfo 7. Results: Sixty-five blood culture positive neonates were included in this study. Early-onset neonatal sepsis and late-onset neonatal sepsis were 35.4% and 54.6%, respectively, and 98.5% sepsis was caused by Gram-negative organism. Common organisms isolated were Klebsiella and Enterobacter. Organisms isolated were resistant to first- and second-line antibiotics and quinolone derivatives. In about 15% cases, bacteria showed resistance to third line of antibiotics used in neonatal sepsis. Conclusion: Gram-negative bacteria and in particular Klebsiella and Enterobacter species are the leading causes of early-onset and late-onset neonatal sepsis. All organisms were resistant to ampicillin, gentamicin, and third generation cephalosporin but resistant to imipenem and meropenem were low.