NEONATAL INTENSIVE CARE UNIT – EMERGING PATHOGENS AND PATIENT OUTCOMES

Background: In developing countries, neonatal sepsis is one of the main reasons for morbidity and mortality. The development of local antibiograms and knowledge about microbial flora and its antibiotic susceptibility pattern will help pediatricians when starting empirical treatment. Objective: To determine the bacteriological profile of organisms in the neonatal intensive care unit and their susceptibility pattern. Methodology: This was a cross-sectional study. Pathogens were identified using standard microbiological techniques of Gram stain, colony morphology, and biochemical tests. Specimens were processed according to the standard guidelines of the Clinical Microbiology Procedures Handbook, 4th edition. The Kirby-Bauer disc diffusion method was used to determine antibiotic susceptibility, which was interpreted according to the Clinical and Laboratory Standards Institute guidelines for 2024 testing. For fungal septicemia, the Vitek 2 system (bioMérieux) was used to determine the susceptibility profile. Their minimum inhibitory concentrations (MIC) were performed and breakpoints were evaluated. Data was analyzed using a statistical package for social sciences and qualitative and quantitative variables were determined. P value less than 0.05 was taken as significant. Results: In our study 208 blood cultures were positive. The culture Positivity rate was 40% in the neonatal Intensive care unit. Septicemia due to Gram-negative organisms was 79 (37.9%) followed by fungal septicemia 68(32.6%) and Gram-positive septicemia was around 61(29.3%). -resistant Acinetobacter baumannii 38 (18.26%) was the most common Gram-negative isolate responsible for sepsis in neonates whereas Methicillin-resistant Coagulase-negative Staphylococcus and Candida parapsilosis were also causing septicemia in neonates. Gram-negative MDROs are the leading cause of neonatal septicemia in our setting. Necessitating local antibiogram and infection control practices are the need of hour Keywords: Antibiogram, Antimicrobial susceptibility, Neonatal intensive care unit, Neonatal sepsis