Bacteriological Profile and Antibiogram of Neonatal Sepsis
DOI:
https://doi.org/10.36570/jduhs.2021.3.1240Keywords:
Common Bacterial Isolates, Common Bacterial IsolatesSepsis, Sepsis, NeonatesAbstract
Objective: To determine the frequency of common bacterial Isolates and antimicrobial sensitivity pattern in patients with neonatal sepsis. Moreover, to assess the clinical profile of neonates with culture positivity.
Methods: This prospective cross-sectional study was conducted at emergency department of National Institute of Child Health, Karachi from September 2017 to March 2018. All clinical suspected neonates with sepsis of either gender were consecutively enrolled. All those neonates already taking antibiotic were excluded. Positive specimens were sub-cultured on blood agar and MacConkey agar and incubated at 37°c for 24hr. Isolated colonies was gram stained and biochemically identified. Common bacterial Isolates was also noted. This information along with certain important neonatal and maternal characteristics were noted.
Results: Of 151 neonates, the mean neonatal age was 11.41 ±6.76 days. There were 87 (57.6%) females and 64 (42.4%) males. Culture positivity was observed in 41 (27.15%) patients. Among 41 culture positive cases, Klebsiella Specie was found positive in majority 14 (34.1%) patients followed by staphylococcus aureus 13 (31.7%), Escherichia coli 8 (19.5%), Coagulative negative staphylococci 5 (12.2%) and group B streptococci 1 (2.4%). A significant association of culture positivity was observed with gestational age (p-value 0.002), low birth weight (p-value 0.039), low APGAR score (p-value 0.018), UTI in mother (p-value 0.026), and chorioamnionitis (p-value 0.005).
Conclusion: Culture positivity was observed in considerable number of suspected neonates. Current magnitude of common bacterial Isolates are Klebsiella Species and Staphylococcus Aureus while Meropenum and Amikacin are common antibiotics sensitivity pattern in patients with neonatal sepsis. .
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Bakhuizen SE, de Haan TR, Teune MJ, van Wassenaer-Leemhuis AG, van der Heyden JL, van der Ham DP, et al. Meta-analysis shows that infants who have suffered neonatal sepsis face an increased risk of mortality and severe complications. Acta Paediatr 2014; 103:1211-8. doi: 10.1111/apa.12764
Turhan EE, Gürsoy T, Ovalı F. Factors which affect mortality in neonatal sepsis. Turk Pediatri Ars 2015; 50:170-5. doi: 10.5152/TurkPediatriArs.2015.2627
Bandyopadhyay T, Kumar A, Saili A, Randhawa VS. Distribution, antimicrobial resistance and predictors of mortality in neonatal sepsis. J Neonatal Perinatal Med 2018; 11:145-153. doi: 10.3233/NPM-1765
Camacho-Gonzalez A, Spearman PW, Stoll BJ. Neonatal infectious diseases: evaluation of neonatal sepsis. Pediatr Clin North Am 2013; 60:367-89. doi: 10.1016/j.pcl.2012.12.003
World Health Organization (WHO). Shining a spotlight on maternal and neonatal sepsis: World Sepsis Day 2017. Available at: https://www.who.int/reproductivehealth/topics/maternal_perinatal/world-sepsis-day/en/ (Accessed 25th January 2021).
Rangel-Frausto MS, Wiblin T, Blumberg HM, Saiman L, Patterson J, Rinaldi M, et al. National epidemiology of mycoses survey (NEMIS): variations in rates of bloodstream infections due to Candida species in seven surgical intensive care units and six neonatal intensive care units. Clin Infect Dis 1999; 29:253-8. doi: 10.1086/520194
Wang J, Zhang H, Yan J, Zhang T. Literature review on the distribution characteristics and antimicrobial resistance of bacterial pathogens in neonatal sepsis. J Matern Fetal Neonatal Med 2020; 26: 1-10. doi: 10.1080/14767058.2020.1732342
Korang SK, Safi S, Gluud C, Lausten-Thomsen U, Jakobsen JC. Antibiotic regimens for neonatal sepsis - a protocol for a systematic review with meta-analysis. Syst Rev 2019; 8:306. doi: 10.1186/s13643-019-1207-1
Bhutta ZA, Naqvi SH, Muzaffar T, Farooqui BJ. Neonatal sepsis in Pakistan. Presentation and pathogens. Acta Paediatr Scand 1991; 80:596-601. doi: 10.1111/j.1651-2227.1991.tb11916.x
Onyedibe KI, Bode-Thomas F, Afolaranmi TO, Okolo MO, Banwat EB, Egah DZ. Bacteriologic profile, antibiotic regimen and clinical outcome of neonatal sepsis in a University Teaching Hospital in North Central Nigeria. J Adv Med Med Res 2015 :567-79.
Lona Reyes JC, Verdugo Robles MÁ, Pérez Ramírez RO, Pérez Molina JJ, Ascencio Esparza EP, Benítez Vázquez EA. Etiology and antimicrobial resistance patterns in early and late neonatal sepsis in a Neonatal Intensive Care Unit. Arch Argent Pediatr 2015; 113:317-23. doi: 10.5546/aap.2015.317
West BA, Peterside O. Sensitivity pattern among bacterial isolates in neonatal septicaemia in port Harcourt. Ann Clin Microbiol Antimicrob 2012; 11:7. doi: 10.1186/1476-0711-11-7
Shaw CK, Shaw P, Thapalial A. Neonatal sepsis bacterial isolates and antibiotic susceptibility patterns at a NICU in a tertiary care hospital in western Nepal: a retrospective analysis. Kathmandu Univ Med J 2007; 5:153-60.
Shaikh M, Hanif M, Gul R, Hussain W, Hemandas H, Memon A. Spectrum and antimicrobial susceptibility pattern of micro-organisms associated with neonatal sepsis in a hospital in Karachi, Pakistan. Cureus 2020; 12:e10924. doi: 10.7759/cureus.10924
Atif M, Zia R, Malik I, Ahmad N, Sarwar S. Treatment outcomes, antibiotic use and its resistance pattern among neonatal sepsis patients attending Bahawal Victoria Hospital, Pakistan. PLoS One 2021; 16:e0244866. doi: 10.1371/journal.pone.0244866
Mudassar S, Nawaz J, Ali M, Rana M, Mahmood F, Iqbal S. Neonatal Sepsis: frequency and antibiogram profiling of bacterial isolates in a tertiary teaching hospital Lahore, Pakistan. Int J Contemp Med Res 2019; 6:J14-J18.
Shah AJ, Mulla SA, Revdiwala SB. Neonatal sepsis: high antibiotic resistance of the bacterial pathogens in a neonatal intensive care unit of a tertiary care hospital. J Clin Neonatol 2012; 1:72-5. doi: 10.4103/2249-4847.96753
Camacho-Gonzalez A, Spearman PW, Stoll BJ. Neonatal infectious diseases: evaluation of neonatal sepsis. Pediatr Clin North Am 2013; 60:367-89. doi: 10.1016/j.pcl.2012.12.003
Shane AL, Sánchez PJ, Stoll BJ. Neonatal sepsis. Lancet 2017; 390: 1770-1780. doi: 10.1016/S0140-6736(17)31002-4
Lorthe E, Quere M, Kayem G. Prolonged latency after preterm premature rupture of membranes: an independent risk factor for neonatal sepsis? Am J Obstet Gynecol 2017; 216:84. doi: 10.1016/j.ajog.2016.08.022
Murthy S, Godinho MA, Guddattu V, Lewis LES, Nair NS. Risk factors of neonatal sepsis in India: A systematic review and meta-analysis. PLoS One 2019 ; 14:e0215683. doi: 10.1371/journal.pone.0215683
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Copyright (c) 2021 Neelum Tahirkheli, Hira Liyakat, Mashal Khan, Bader -u-Nisa, Muhammad Ashfaq
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