Abstract
Objective Neonatal sepsis remains to be a major cause of neonatal mortality and morbidity in
developing countries like India. This study was aimed to identify the bacterial isolates
and study antimicrobial profile among admitted babies with neonatal sepsis.
Methods A cross-sectional retrospective study was conducted in the sick neonatal wards and
neonatal intensive care unit of Burdwan Medical College from March 2017 to February
2018. A total of 299 neonates suspected of neonatal sepsis was evaluated. Diagnosis
of neonatal sepsis was made through positive blood culture. Positive samples were
subcultured on specific media like blood, chocolate agar, nutrient, Muller–Hinton
agar, and MacConkey plates, and the organisms were identified by gram staining and
biochemical reactions. Antibiotic susceptibility was tested by Kirby–Bauer disc diffusion
method.
Results Overall, 118 blood cultures out of 299 patients (39.46%) were bacteria-positive.
Of these, 31.3% cases had early-onset septicemia (EOS), while 68.6% had late-onset
septicemia (LOS). The prevalence of sepsis was higher in males (55.9%), preterm babies
(58.47%), and low birth weight neonates (37.29%). The highest bacterial strains isolated
were Klebsiella
spp. (33.8%) followed by Staphylococcus aureus (25.8%), Escherichia coli (22.8%), coagulase-negative Staphylococcus (12.5%), Pseudomonas
spp. (2.5%), Enterococcus
spp. (1.6%), Acinetobacter
spp. (0.8%), and Burkholderia
spp. (0.8%). Resistance is high among the gram-negative bacteria, like Enterobacter and Pseudomonas , for piperacillin–tazobactam and cephalosporins but they are mostly sensitive to
meropenem, colistin, and levofloxacin. Gram-positive bacteria, like S. aureus , are mostly resistant to amoxicillin–clavulanic acid but highly sensitive to linezolid,
vancomycin, azithromycin, and teicoplanin.
Conclusion K. spp. and S. aureus are the most common isolates in our study. The level of resistance among the organisms
toward conventional antibiotics like amoxicillin, cephalosporins, and piperacillin–tazobactum
is alarmingly high. This warrants formulation of a hospital-specific guideline for
antibiotic use and periodic review of the same.
Keywords bacterial sepsis - antibiotic susceptibility - early-onset sepsis - late-onset sepsis
- neonates
