Community Acquired Neonatal Sepsis: A Study Of Bacteriological Profile And Antibiogram

Abstract

Objective: Neonatal sepsis is a major cause of morbidity and mortality of newborns (< 1 month of age). Septicemia and drug resistance is a predominant issue for neonatal death in Bihar. This study is intended to find bacteriological profile of community acquired neonatal sepsis and antibiotic susceptibility pattern of the isolates from neonates. Methods: It was a prospective study undertaken on 310 neonates suspected of community acquired neonatal sepsis. All these cases fulfilled the inclusion criteria required for the study. Blood culture of these cases was performed by Mackie and McCartney method and antibiotic sensitivity by Kirley-Baner’s disc diffusion method. Results: 240 (77.4%) cases showed positive blood culture. Gram negative isolates (N=158;65.83%) were more frequent than gram positive isolates (N=82;34.16%). Most common isolate was Klebsiella Pneumoniae (N=78%;32.50%) followed by Staphylococcus Aureus (N=67;27.91%), E.Coli (N=38;15.83%), Pseudomonas Aeroginosa (N=28;11.66%), Acinetobacter (N=14;5.83%), Enterococcus(N=8;3.33%) and Coagulase Negative Staphylococcus Aureus (N=7;2.91%). Both gram negative as well as gram positive isolates showed high resistance to ampicillin and gentamycin. Gram negative isolates were highly sensitive to Polymixin B and Meropenem whereas gram positive isolates were highly sensitive to Linezolid and Vancomycin. Conclusion: Gram negative bacteria were more frequent causes of community acquired neonatal septicemia than gram positive isolates. Both gram positive and negative isolates showed poor sensitivity towards conventional first line antibiotics, rather were mainly susceptible to higher antibiotics. So the knowledge of the pattern of bacteriological isolates and their antimicrobial susceptibility pattern can be very helpful for prompt treatment of such patients, to decrease neonatal morbidity and mortality as well as reducing the emergence of multi-drug resistant organisms.