Five year trend of aerobic bacteria isolated from patients with neonatal sepsis in a tertiary care centre, North Kerala, India

Authors

  • Ramakrishna Pai Jakribettu Department of Microbiology, MES Medical College, Perinthalmanna, Kerala, India
  • Bindu A. Department of Paediatrics, MES Medical College, Perinthalmanna, Kerala, India
  • Twinkle V. Department of Paediatrics, MES Medical College, Perinthalmanna, Kerala, India
  • Fysal Neliyathodi Department of Paediatrics, MES Medical College, Perinthalmanna, Kerala, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20202132

Keywords:

Antibiotic, Neonatal Sepsis, Resistance, Trend

Abstract

Background: Antimicrobial resistance has reached to a significant proportion globally. This antimicrobial resistance increases the cost of health care in addition to the existing burden of the prevalence of infectious disease in developing countries. We need to have institutional protocols based on the standard guidelines. It is important for the clinician to use antibiotics only when it is necessary. Thus, the present study was undertaken to know the bacteriological profile and antibiogram of aerobic pathogens isolated from blood samples of patients in NICU during 2012 -2016.

Methods: This retrospective study was conducted at Clinical Microbiology and Paediatric department, MES Medical College, Perinthalmanna, between January 2012 to December 2016. All blood samples from suspected Neonatal sepsis were included in the study. The positive samples were cultured as per standard microbiological procedure and antimicrobial susceptibility was done as per CLSI guidelines.

Results: During the study period of 5 years, out of 2022 blood samples received from NICU 251 (12.41%) were positive. During the study period, male patients (146, 58.17%) were more than the female. The Gram-positive isolates accounted for 135 (53.78%) isolates compared to Gram negative isolates 115 (45.81%). Authors had a single isolate of Candida species in 2014. Among the Gram positive isolates, Staphylococcus aureus (77/135) was the commonest and Klebsiella pneumoniae (51/115) among the Gram negative isolates. There was a steady rise in MRSA isolation rate in five years. The commonly used antibiotic in neonatal sepsis i.e., Ampicillin and Gentamicin, was observed to have high level of resistance. No resistance was observed against Vancomycin, Teicoplanin, Linezolid among Gram positive and against Carbapenems among Gram negative pathogens.

Conclusions: As Gram positive organisms were the most common pathogen isolated in patients with neonatal septicaemia in our study population. The Staphylococcus aureus and Klebsiella pneumoniae were the common isolates. Following this study, Piperacillin tazobactum is considered as the drug for empirical therapy. Vancomycin and carbapenems are considered as reserve drug and escalated only following the report from microbiology report.

References

Cantas L, Shah SQ, Cavaco LM, Manaia C, Walsh F, Popowska M, et al. A brief multi-disciplinary review on antimicrobial resistance in medicine and its linkage to the global environmental microbiota. Frontiers Microbiol. 2013 May 14;4:96.

The world medicine situation 2011. Available at: http://www.who.int/medicines/areas/policy/world_medicines_situation/WMS_ch14_wRational.pdf. Accessed on 12 October 2019.

Lee CR, Cho IH, Jeong BC, Lee SH. Strategies to minimize antibiotic resistance. Int J Environm Res Pub Health. 2013;10(9):4274-305.

CLSI. Performance Standards for Antimicrobial Susceptibility testing. 24th ed. CLSI supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute; 2014.

Bhat R, Lewis LE, Vandana KE. Bacterial isolates of early-onset neonatal sepsis and their antibiotic susceptibility pattern between 1998 and 2004: an audit from a center in India. Italian J Pediatr. 2011 Dec;37(1):32.

Marando R, Seni J, Mirambo MM, Falgenhauer L, Moremi N, Mushi MF, et al. Predictors of the extended-spectrum-beta lactamases producing Enterobacteriaceae neonatal sepsis at a tertiary hospital, Tanzania. Int J Medi Microbiol. 2018 Oct 1;308(7):803-11.

Mahallei M, Rezaee MA, Mehramuz B, Beheshtirooy S, Abdinia B. Clinical symptoms, laboratory, and microbial patterns of suspected neonatal sepsis cases in a children's referral hospital in northwestern Iran. Medicine. 2018 Jun;97(25).

Sharma CM, Agrawal RP, Sharan H, Kumar B, Sharma D, Bhatia SS. “Neonatal sepsis”: bacteria & their susceptibility pattern towards antibiotics in neonatal intensive care unit. J Clini Diagn Res: JCDR. 2013 Nov;7(11):2511-3.

Yadav NS, Sharma S, Chaudhary DK, Panthi P, Pokhrel P, Shrestha A, et al. Bacteriological profile of neonatal sepsis and antibiotic susceptibility pattern of isolates admitted at Kanti Children’s Hospital, Kathmandu, Nepal. BMC Res Notes. 2018 Dec;11(1):301.

Jyothi P, Basavaraj MC, Basavaraj PV. Bacteriological profile of neonatal septicemia and antibiotic susceptibility pattern of the isolates. J Natural Sci, Biol, Medi. 2013 Jul;4(2):306.

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 Clini Neonatol. 2012;1(2):72-5.

Huang YC, Wang YH, Chou YH, Lien RI. Significance of coagulase-negative Staphylococci isolated from a single blood culture from neonates in intensive care. Ann Trop Paediatr. 2006;26:311-8.

Agrawal M, Chaturvedi P, Dev SK, Narang P. Coagulase negative staphylococcal septicemia in newborns. Ind Pediatr. 1990, 27:163-9.

Chandel DS, Johnson JA, Chaudhry R, Sharma N, Shinkre N, Parida S, et al. Extended-spectrum β-lactamase-producing Gram-negative bacteria causing neonatal sepsis in India in rural and urban settings. J Medi Microbiol. 2011 Apr;60(Pt 4):500.

Mustafa M, Ahmed SL. Bacteriological profile and antibiotic susceptibility patterns in neonatal septicemia in view of emerging drug resistance. J Medi Allie Scie. 2014;4(1):2.

Downloads

Published

2020-05-22

Issue

Section

Original Research Articles