Neonatal sepsis: epidemiology, clinical spectrum, recent antimicrobial agents and their antibiotic susceptibility pattern

Abstract

Background: Neonatal sepsis is one of the most common causes of neonatal mortality in the developing world. This study aims to determine the incidence, the bacteriological profile of neonatal septicaemia, their antibacterial susceptibility pattern. Methods: It is a prospective study, carried out in the tertiary care NICU of S.P. Medical College, Bikaner, Rajasthan, from January 2014 to October 2014. Blood culture specimens were collected from neonates, identification of organisms, their antibiotic susceptibility pattern detection was done. Results: Gram negative organisms were more common (71.42%) than gram positive (28.57%). Klebsiella was the most common pathogen (48.21%) in both early and late onset septicemia. In third generation cephalosporins, only one organism (Strept. faecalis) is sensitive to ceftriaxone but cefoperazone and cefotaxim both have activity against Klebseilla and coagulase negative Staphylococcus. Ceftazidime showed better results and active against Klebseilla, E. coli, pseudomonas and unidentified gram negative bacilli. In aminoglycosides amikacin has much better results than gentamicin. Piperacillin had advantage over ampicillin. All organisms except E. coli showed sensitivity to cefotaxime. Vancomycin had good activity against gram positive organisms (enterococcus, CONS, MRSA). Neonatal mortality rate was 23.43%. Conclusions: Neonatal sepsis is one of the major causes of morbidity and mortality in the newborns. Prematurity, low birth weight, prolonged rupture of membranes are major risk factors predisposing neonate to sepsis. This study, showed alarming results of antibiotic sensitivity patterns. The antibiotics which are routinely used like ampicillin and ceftriaxone showed poor activity against most of the organisms.