Neonatal Sepsis in a Tertiary Care Hospital in South India: Bacteriological Profile and Antibiotic Sensitivity Pattern

Abstract

To identify the common bacterial pathogens associated with neonatal sepsis and their antibiotic susceptibility pattern. This prospective observational cohort study was done in a tertiary care teaching hospital located in South India for a period of 2years. All the admitted inborn and out born neonates during this study period were screened for sepsis based on the clinical features and septic screening. All infants satisfying the criteria for sepsis were subjected to blood culture. Growths, if any, were noted and standard antibiotic sensitivity testing was done by Kirby-Bauer disk diffusion method. The Chi-square test or Fisher's exact test was used to compare two groups. Out of the 120 clinically suspected and positive screening test cases of neonatal sepsis, 41.6% (50 of 120) were culture-proven cases of neonatal sepsis. Klebsiella pneumoniae was isolated from 66% of culture positive cases followed by Coagulase-negative staphylococci in 12% of cases. Klebsiella pneumoniae was resistant to most of the antibiotics tested except amikacin and meropenem. Of the total 33 Klebsiella pneumoniae isolates, 16 (32.0%) were ESBL producers. The prevalence of ESBL producing Klebsiella pneumoniae during two month outbreak and rest of the study period was 83.3% (15 of 18) and 20% (3 of 15) respectively (P value 0.0010). Klebsiella pneumoniae was the most common agent causing both early-onset and late-onset sepsis and significantly associated with sepsis in inborn babies. Amikacin should be used along with the third-generation cephalosporins for empirical treatment of gram-negative neonatal sepsis.