Sepsis in Neonates: Prevalence of Micro-Organisms and Their Susceptibility Pattern in Neonatal Intensive Care Unit of a Tertiary Care Hospital - A Retrospective Study

摘要

The main aim of doing this study was to analyze the existing resistance pattern and change the empirical regimen that is currently employed in our unit. Retrospective observational study was carried out at Neonatal Intensive Care Unit (NICU), in a tertiary care private hospital to observe the prevalence of organisms and their resistance. Incidence of suspected neonatal sepsis among admitted neonates in our unit during study period was 58% (1942). Among the 1942 neonates with suspected sepsis only 90 (4.6%) had documented microbial infections. Pathogenic organisms were isolated in 71 cases and the rest of the growth was considered as contaminants. In the 71 documented cases 85.91% (61 neonates) were bacteremia and 14.08% (10 neonates) were yeasts. Among the 61 neonates with bacteremia, gram negative bacilli was the most common accounting for 75.4% (46) of cases and gram positive cocci contributed to 24.5% (15) of cases. Klebsiella pneumoniae 48.9%, Pseudomonas aeruginosa 14.89% and Escherichia coli 10.6% were the common gram negative isolates. In the gram positive group, most common isolated bacteria were Staphylococcus sps 11.4% (7 cases), Enterococcus sps 8.1% (5 cases) and Streptococcus agalacticae 4.9% (3 cases). Out of 23 Klebsiella pneumoniae, 39.1% were producing Carbapenamase, 30.4% were Multi Drug Sensitive (MDS), 26% were Extended Spectrum Beta-Lactamase (ESBL) and 4.3% were AmPC beta lactamase producer. In the gram-positive bacteremia, 46.6% were Staphylococcus sps, 33.3% were Enterococcus species and 20% were Streptococcus agalactiae. There were 10 proven fungal sepsis during the study, 30% were Candida albicans which had 100% sensitivity to fluconazole. Candida non albicans like C. glabrata, C. parapsilosis and C. krusei were isolated in 2 cases each and they had varying resistance to fluconazole.