Prevalence of Drug Resistance in Neonatal Sepsis- A Prospective Study

Abstract

Background: Infections are the single largest cause of neonatal deaths globally. The emergence of Methicillin resistant Staphylococcus aureus (MRSA) and extended spectrum β– lactamases (ESBLs) in neonatal intensive care unit patients is increasing. This study aims to find out the bacteriological profile in neonatal sepsis and study their antimicrobial susceptibility pattern.

Method: A total of 360 suspected neonatal septicaemic cases admitted in SSIMS & RC at NICU were enrolled. Blood sample was collected for blood culture. The isolates were identified by standard biochemical tests and susceptibility performed using the disc diffusion methods as per Clinical laboratory Standard Institute (CLSI) recommendations. Staphylococcus aureus were tested for Methicillin resistance using Cefoxitin disc (30μg), ESBL was detected using combined disc method.

Results: Out of 360 cases 160 were bacteriologically positive, Klebsiella was the most common organism isolated (21%), followed by Staphylococcus aureus (20%) Acinetobacter (15%), Pseudomonas (13%). Maximum sensitivity was seen by Linezolid, Erythromycin for Gram positive organisms and Gram negative organisms were sensitive to Piperacillin/ Tazobactum, Imipenem, Levofloxacin, Meropenem. MRSA was detected in 53% isolates, ESBL production was majorly seen in E.coli, followed by Klebsiella.

Conclusion: Klebsiella spp. and Staphylococcus aureus were the commonest bacteria causing neonatal sepsis in this centre. Multidrug resistance among the isolates was common. Early diagnosis and institution of specific antibiotics after studying the sensitivity pattern will help in reducing neonatal morbidity and mortality and prevent emergence of drug resistant strains.