Nandita Pal1, Sanat Kumar Dolui2, Bhuban Majhi3, Manisha Das4
BACKGROUND
Septicaemia is a leading cause of morbidity and mortality in neonates.
Antimicrobial prescription for neonatal septicaemia (NS) should be wisely used
depending on the regional spectra of infecting microbes and their antimicrobial
resistance (AMR) patterns which vary over time, place and host factors.
METHODS
This was a descriptive cross-sectional study conducted from January 2017 to June
2017 among 102 cases of NS admitted in neonatal intensive care units (NICU).
Demographic data of the concerned neonates was collected through a predesigned
checklist. Blood collected from neonates was processed for culture and
sepsis screen. Antimicrobial susceptibility testing was performed for the cultured
isolates and phenotypic AMR patterns were observed.
RESULTS
Most of the studied neonates had subnormal birth weight (86). Blood culture
showed predominance of gram-negative bacilli (GNB) among which Klebsiella
pneumoniae was the most common followed by Burkholderia cepacia complex.
Coagulase negative staphylococcus species (CoNS) was most numerous among
the cultured gram-positive cocci (GPC). Candidemia of late onset was confirmed
in 25 neonates. Early onset sepsis was predominantly caused by GNB (29 / 31)
predominated by Klebsiella pneumoniae. Multi drug resistant (MDR) pathogens
viz., extended spectrum beta-lactamase (ESBL) producing GNB, carbapenem
resistant-GNB (CR-GNB) and methicillin resistant staphylococcus (MRS)
phenotypes were notably prevalent.
CONCLUSIONS
Multidrug resistant microorganisms are notably prevalent in neonatal septicaemia.
In clinically suspected very sick septicaemic neonates not showing much
improvement with guideline-led empirical antimicrobial therapy, an early
antibiogram guided change over to meropenem and amikacin or even to colistin
in case of reported carbapenem resistance, is highly recommended.
