Changing Pattern of Bacteriological Profile, Antimicrobial Resistance and Mortality in Neonatal Sepsis in a Developing Country: A Retrospective Study

Authors

  • Anindya Kumar Saha Department of Neonatology, Institute of Post Graduate Medical Education & Research , Kolkata, India
  • Abhishek Kumar Tiwari Paediatrics, Jagannath Gupta Institute of Medical Sciences , Budge Budge, Kolkata, India
  • Pinaki Chattopadhyay Department of Neonatology, Institute of Post Graduate Medical Education & Research , Kolkata, India
  • Suchandra Mukherjee Department of Neonatology, Institute of Post Graduate Medical Education & Research , Kolkata, India
  • Bijan Saha Department of Neonatology, Institute of Post Graduate Medical Education & Research , Kolkata, India

DOI:

https://doi.org/10.3126/jnps.v41i3.33267

Keywords:

Klebsiella, Mortality, Multi-drug resistance, Newborn, Sepsis

Abstract

Introduction: Neonatal sepsis is one of the major contributors of mortality and morbidity among neonates. Irrational and overuse of antibiotics have led to an increase in antimicrobial resistance. This study was undertaken to investigate the bacteriological profile, antimicrobial resistance and predictors of mortality among blood culture-positive cases of neonatal sepsis.  

Methods: Demographic and bacteriological data were collected from electronic and manual case records. Automated BACTEC 9050 system using Peds Plus Vial was used for blood culture. Multidrug resistance was defined as a resistance to any three of five antibiotic classes like aminoglycoside, carbapenem, extended spectrum cephalosporins, fluoroquinolones and piperacillin. 

Results: Among 7180 admitted neonates, 433 (6.03%) were blood culture positive with early onset sepsis (EOS) in 50.1% of cases. Gram negative bacteria was the causative organism in 371 (85.7%) babies with klebsiella being the commonest pathogen (43.6%). The pathogen mix of early onset and late onset sepsis was similar and 90% of gram negative isolates were resistant to penicillin group. Multi drug resistance (MDR) was found in 51.2% of the gram negative organisms. EOS (Odds ratio 1.99; 95% confidence interval, 1.29-3.05) and MDR (Odds ratio 2.07; 95% confidence interval, 1.77-4.12) were independently associated with neonatal death due to sepsis.

Conclusions: Gram-negative pathogens, specifically klebsiella accounted for a huge burden of neonatal sepsis. EOS and MDR were found to be independent predictors of death due to such sepsis. This study calls for multicentric studies on early onset neonatal infection and its relationship with pathogenic maternal flora.  

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Published

2021-12-31

How to Cite

Saha, A. K., Tiwari, A. K., Chattopadhyay, P., Mukherjee, S., & Saha, B. (2021). Changing Pattern of Bacteriological Profile, Antimicrobial Resistance and Mortality in Neonatal Sepsis in a Developing Country: A Retrospective Study. Journal of Nepal Paediatric Society, 41(3), 358–366. https://doi.org/10.3126/jnps.v41i3.33267

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Original Articles