Blood culture and drug sensitivity in neonatal sepsis and its outcome

Background: Nearly one-third of neonatal mortality in India is due to neonatal sepsis and death occurs in 30% of culture-positive neonates. Pathogens such as Klebsiella pneumoniae and Escherichia coli are the most common bacteria responsible for neonatal sepsis in India and South Asia. Methods: It was a retrospective study conducted in newborn intensive care units (NICUs) of J. K. Lon Hospital, Government Medical College, Kota, Rajasthan from January 2024 to May 2024. All neonates (<28 days of life) with – symptoms of sepsis or presence of maternal risk factors of sepsis were included in this study. Blood was collected in a BACT/ALERT® culture bottle. Blood culture was done by an automated method in BD BACTEC FX40. Results: Blood cultures were sent for 733 neonates out of which 209 were culture positive. Most common organism isolated was Klebsiella, second most common organism isolated was E. coli, third most common organism isolated was Staphylococcus aureus. Fourth most common organism was Pseudomonas and the rest were Acinetobacter, coagulase-negative Staphylococci (CoNS), Enterococcus and yeast. Mortality due to sepsis is 22%. Conclusions: Klebsiella followed by E. coli was found to be the most common cause of sepsis in present study NICU. A high degree of resistance of organisms to Aminoglycosides and penicillin group particularly Amoxyclav calls for a re-evaluation of antibiotic policy and protocols for empirical treatment in neonatal sepsis.