NEONATAL SEPSIS-CLINICAL PROFILE, BACTERIOLOGY AND ANTIBIOTIC SENSITIVITY PATTERN IN A TERTIARY CARE CENTRE.

Neonatal sepsis poses significant threat to survival of neonates. The clinical features of neonatal sepsis being nonspecific, pose a great challenge for prompt diagnosis. Present study aims to study clinical profile of neonatal sepsis and to describe the spectrum of bacteria in cases of neonatal sepsis in a tertiary care centre. The observational study was conducted among the 350 neonates admitted into the NICU with signs and symptoms of neonatal sepsis. Neonates were assessed with proper history, and clinical examinationas per proforma. After enrolment complete blood count (CBC), C reactive protein(CRP), blood culture and other relevant investigations were sent. After sample collection, empirical antibiotic therapy was started according to antibiotic policyof Neonatal Intensive Care Unit (NICU). Among 350 neonates with suspected neonatal sepsis, 115 (32.85 %) neonates found to be blood culture positive (32.85%). Of these 13 were Early onset sepsis and 102 were late onset sepsis.Of 115 positive blood cultures, 81(70.43 %) were gram negative microorganisms and 34 (29.56 %) were gram positive. Among the gram negative, Klebsiella pneumoniae was most common isolate (40%) followed by E coli (18.26%). Among gram positive, Staphylococcus aureus was leading pathogen isolated (27.82%) followed by Staphylococcus epidermidis (1.73%). The incidence of late onset sepsis in neonates is rising.Most prevalent presenting symptoms in neonates with sepsis was refusal to feed followed by lethargy. Klebsiella was the predominant gram-negative organism and Staphylococcus aureus was the predominant gram-positive isolates from blood culture. Emergence of resistance to first line antibiotics is a major concern.