RISK FACTORS, CLINICAL PROFILE AND ANTIBIOTIC SENSITIVITY PATTERN OF NEONATAL SEPSIS IN A TERTIARY CARE HOSPITAL IN NORTH INDIA

Background: Neonatal septicaemia, an immune systemic dysregulation due to bloodstream infections, causes 99% of global neonatal mortality in the low and middle income countries (LMICs) making it a key global concern. It is a major obstacle in achieving the Sustainable Development Goal 3, which aims to reduce neonatal mortality to at least 12 per 1000 live births by 2030.Gaining insights into the complex associations of neonatal sepsis and mortality will be benecial in guiding interventions to reduce neonatal sepsis.Aims and Objectives: To study the association of risk factors, prole of pathogens, their antibiotic susceptibility pattern and outcome of neonates in early onset and late onset neonatal septicaemia. Materials and Methods: This is a prospective observational study conducted in a tertiary care hospital from October 2022 to September 2023for a period of one year. All neonates admitted to the neonatal intensive care unit with a clinical diagnosis of suspected neonatal sepsis were assessed. After obtaining written consent from their guardians, a detailed history and relevant investigations were recorded. Blood samples (1-2ml) were collected under aseptic precautions and processed according to standard microbiological procedures for identication of the pathogen based on colony morphology and biochemical reactions. The antibiotic susceptibility was performed by modied Kirby- Bauer's disk diffusion method. Results: In the present study 221 Clinically Suspected Cases of Neonatal Septicaemia (CSNS) were enrolled. The primary presenting features were respiratory distress in 38.46%, n=85), lethargy in 33.03% (n=73), along with any symptom like refusal of feeds, weak cry, abdominal distension, fever, diarrhoea, vomiting, and/or jaundice. Among these CSNS, males accounted for 64.7% (n=143) and 35.3% (n=78) were females. CSNS in full-term was seen in 57.5%(n=127) while42.5% (n=94) were preterm and 52%(n=114) were Low Birth Weight (LBW) babies. Growth on blood culture was observed in 39.4% (n=87) and out of these blood culture positive cases,72% (n=63)were delivered vaginally while 28% (n=24) had caesarean section. Signicant association of blood culture positivity was seen between male gender and vaginal delivery (p< 0.05). Gram-positive bacteria were isolated in 82.75% and Gram-negative isolates were obtained in 13.85%of culture positive cases. Most of the Grampositive organisms were susceptible to linezolid and cotrimoxazole. Gram negative bacilli were found to be 100% sensitive to gentamicin and imipenem.