Neonatal sepsis and resistance pattern of isolates in Tertiary level neonatal unit: Time to evaluate the empirical antibiotics selection

  • Lubna Ehtizaz
  • Shahzad Haider Wah Medical College
  • Madiha Fayyaz
  • Ambreen Ansar
  • Sajid Nazir
  • Saima Rafique
Keywords: Neonatal sepsis, Resistance, Antibiotics

Abstract

Objective: To find out the most common organisms involved in neonatal sepsis origination and observe the pattern of antibiotic sensitivity and resistance of bacterial isolates.
Materials and Methods: This descriptive cross-sectional study was conducted at the Department of Paediatrics Izzat Ali Shah Hospital, Wah Cantt. Out of 420 patients admitted with sepsis in NICU, 19.5% of patients with positive blood cultures were included in the study. A consecutive, non-probability sampling technique was used.
Results: Out of 82 positive blood cultures gram-positive bacteria were observed in 19 patients (23.2%) and gram-negative bacteria were seen in 63 patients (76.8%). The most common gram-negative pathogens isolated were Acinetobacter (29.3%) and Klebsiella (24.4%). Staphylococcus aureus (12.2%) was the commonest gram-positive organism isolated. Gram-negative organisms showed maximum sensitivity to Tigecycline and Colistin and were resistant to Cefixime, Aztreonam, Amoxicillin, and Ceftriaxone. Gram-positive bacteria were sensitive to Teicoplanin, Linezolid, and Vancomycin while resistance was shown to penicillin and amoxicillin.
Conclusion: The current study showed that gram-negative bacteria were the major contributors to sepsis in the respective setup and showed resistance to first-line antibiotics such as Penicillins and Cephalosporins. Strict infection control measures need to be implemented to avoid the emergence of resistant strains of pathogens in NICUs. This will help to reduce the incidence of neonatal sepsis leading to mortality.

References

1. Suman C, Sindhu S, Ramesh A, Sally E, Mike S, Sankar M et al. Neonatal sepsis in South Asia: huge burden and spiraling antimicrobial resistance.BMJ 2019; 364. DOI: https://doi.org/10.1136/bmj.k5314
2. V Z Alonso, JO Theresa .Challenges in the diagnosis and management of neonatal sepsis, Journal of Tropical Pediatrics. 2015; 61, 1–13.
3. L Xiaoxia, D Xiangyu, S Peng ,Z Yiqing , H Yidie, L Qin,L Jinmiao, L Zhiping, Z Lin. Clinical features and antimicrobial susceptibility profiles of culture-proven neonatal sepsis in a tertiary children's hospital. Medicine (2019) 98:12
4. Huggard D, Drew R, McCallion N. Neonatal Bacteraemia Among 112,360 Live Births. Ir Med J. 2016 Oct 12;109(9):467.
5. Lakhey A1, Shakya H . Role of sepsis screening in early diagnosis of neonatal sepsis. Journal of Pathology of Nepal (2017) Vol. 7,1103-1110.
6. T Ghafoor, A Hussanain, MM Qureshi, T Mehmood, L Ali. Antimicrobial susceptibility pattern of blood culture isolates from patients with suspected neonatal sepsis in a tertiary care hospital in Pakistan. Sri Lankan Journal of Infectious Diseases 2020 Vol.10 (1):30-37
7. A Madiha, Y Muhammad, K Arshad, Q Khadija, A Zeeshan. Neonatal Sepsis In A Tertiary Care Hospital: Bacteriological Profile And Its Antimicrobial Sensitivity, Pak Armed Forces Med J 2018; 68 (6): 1654-58.
8. U Obaid , K Aftab, A Arif, A Israr, A Tasleem and Gandapor A J. Antibiotic Sensitivity pattern of Bacterial Isolates of Neonatal Septicemia in Peshawar, Pakistan. Archives of Iranian Medicine, 2016; 19(12): 866 – 869
9. Bhamare Sunil B, Karmarkar A. Study of prevalence of methicillin and vancomycin resistance in multidrug resistant coagulase negative staphylococci. Inter J Health Care Bio Med Res. 2014; 2(3): 67 – 72
10. Haider S,Nazir S,Sehar K and Saleem M.Mortality associated with isolated pathogens in neonatal sepsis at Izzat Ali Shah Hospital, Wah Cantt. Med Forum Volume 29 No.9 Sept 2018.
11. Mushtaq S, Ashraf S, Ghazal L, Zahid R, Hussain B, Dr J. Bacteriological Profile and their Susceptibility Pattern in Neonatal Intensive Care Unit at Tertiary Care Hospital in Wah. JRMC [Internet]. 30Sep.2020 [cited 25Jan.2021];24(3):219-24. Available from: https://journalrmc.com/index.php/JRMC/article/view/1310
12. Abbasi NB, Jabeen N, Khatoon S . Neonatal Sepsis; Common Bacterial Isolates And Their Antimicrobial Susceptibility Patterns In Neonatal Intensive Care Unit, Islamabad.Professional Med J 2017;24(10):1455-1460.
13. 12. P. Jyothi, Metri C. Basavaraj, Peerapur V. Basavaraj. Bacteriological profile of neonatal septicemia and antibiotic susceptibility pattern of the isolates. Journal of Natural Science, Biology and Medicine, July 2013 , Vol 4, Issue 2
14. Haritha J , Hemasri P, Renuka A, Surekha A. Bacteriological Profile of Neonatal Septicemia and Antibiogram of Isolates. Journal of Dental and Medical Sciences. Volume 18, Issue 2 Ser. 17 (February. 2019), PP 52-54.
15. Sana F, Satti L, Zaman G, Gardezi A, Imtiaz A, Khadim T. Pattern of Blood Stream Infections and their antibiotic susceptibility profile in a Neonatal intensive care unit of a tertiary care hospital; a current perspective. J Pak Med Assoc. Vol. 69, No. 11, November 2019.
16. Asghar S, Khan JA, Mahmood MS, Arshad M I, A Cross-sectional Study of Group B Streptococcus–Associated Sepsis, Coinfections, and Antibiotic Susceptibility Profile in Neonates in Pakistan. Advances in Neonatal Care . Vol. 00, No. 0 . pp. 1–11
17. Mahalle M, Rezaee M A, 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) 97:25.
18. Ejaz A, Khawaja A, Arshad F, Tauseef A, Ullah R, Ahmad I. Etiological Profile and Antimicrobial Patterns in Blood Culture Specimens in a Tertiary Care Setting. . Cureus 12(10): e11000
Published
2021-06-30
How to Cite
1.
Ehtizaz L, Haider S, Fayyaz M, Ansar A, Nazir S, Rafique S. Neonatal sepsis and resistance pattern of isolates in Tertiary level neonatal unit: Time to evaluate the empirical antibiotics selection. JRMC [Internet]. 30Jun.2021 [cited 7Dec.2021];25(2):264-9. Available from: https://journalrmc.com/index.php/JRMC/article/view/1605
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Articles