To Study the Microbiological Profile and Antibiotic Sensitivity Patterns in Neonatal Sepsis in a Tertiary Care Hospital

Background: Neonatologists face a perpetual challenge in managing neonatal septicaemia due to changing patterns of the microbial flora and their antibiotic sensitivity. Neonatal sepsis is a major cause of neonatal mortality, the clinical outcome of which depends on early diagnosis and initiation of appropriate antibiotics. The emergence of multi-drug resistant strains has limited the choice of available antibiotics. Thus, antibiotic resistance pattern of pathogens is critical for both therapy and infection control. The present study was designed to evaluate the microbiological profile and antibiotic sensitivity patterns in neonatal sepsis patients. Methods: We analyzed records of a total of 160 neonates with clinical sepsis who were admitted in our NICU during the study period and had blood culture sent for isolation of microbial agent. Out of 160 neonates (99 male and 61 female) grew pathogens on blood culture. Results: In our study, 44 (27.5%) had positive blood cultures. However, 92 (57.5%) sepsis-suspected newborns showed negative blood cultures. 27.5 % of neonates with culture-positive sepsis had gram-positive infections, while 57.5 % had gram-negative infections. In Gram-positive sepsis patients, Acinetobactor 7 (4.38%), CONS 6 (3.75%), Escherichia Coli 8 (5%), Klebsiella Pneumoniae 13 (8.13%), MRSA 4 (2.50%), and Pseudomonas 6 (3.75% Further analysis showed that 27.5% of Gram-positive patients were susceptible to Piperacillin, Tazobactum, Imipenem, Amikacin, and Vancomycin. 72.5% of Gram-negative patients responded to Piperacillin + Tazobactum and Imipenem. In our 160 newborn sepsis cases, 44% (27.5) were culture positive. Most culture-positive cases were gram negative (72.5%, 116 cases), followed by positive. Preterm and low-birth-weight babies were more prone to sepsis. Many Gram-negative microbes were isolated. We found that most Gram-negative organisms were sensitive to Imipenem, followed by Piperacillin + Tazobactum, Cefoperazone + Sulbactum, Ceftazidime, Ceftriaxone, and Amikacin. Most Gram-positive organisms were responsive to Vancomycin, then Amikacin, Imipenem, Piperacillin + Tazobactum, Ceftriaxone, and Cefoperazone + Sulbactum. Conclusion: Most Enterobactericeae isolates from neonatal sepsis produced ESBL. Gram-negative bacilli were resistant to ampicillin, gentamicin, and ceftriaxone. Vancomycin, teicoplanin, and linezolid were sensitive to gram-positive isolates in vitro, while Cefepime-tazobactam and imipenem were sensitive to gram-negative isolates. In our institution, CONS and Candida spices were the most common neonatal sepsis isolates. Preterm and low-birth-weight babies were more prone to sepsis. Many Gram-negative microbes were isolated. Despite their low virulence and commensality, they can cause neonatal sepsis, requiring strict observation and infection control. Our data suggests that Piperacillin + Tazobactum and Amikacin as first antibiotics would be most effective.