Aetiology and antimicrobial resistance of neonatal sepsis at a tertiary care centre in eastern India: a 3 year study

Abstract

Objective: To review aetiological agents of neonatal sepsis and their antibiotic resistance pattern over the past 3 years, at a 20 bedded Level III neonatal intensive care unit (NICU) in eastern India.

Methods: Blood culture reports of culture positive sepsis were reviewed for the period 2007-2009. Demographic data of the babies was collected.

Results: Blood culture was done for 997 neonates with suspected clinical sepsis. The incidence of culture proven neonatal sepsis among inborn babies was 14.8/1,000 live births. The proportion of culture positive sepsis for outborn babies admitted in neonatal intensive care unit was 8.3%. Gram negative aetiology was predominant (71.6%), with Klebsiella pneumoniae being the most common isolate. Non fermenting Gram negative bacilli like Acinetobacter sp emerged as an important cause of infection. The aetiology of early onset and late onset sepsis was similar. The proportion of resistance to common first and second line antibiotics like ampicillin (98.5%), gentamicin (84.4%), amikacin (65.6%) and cefotaxime (81.3%) was high.

Conclusions: The present study is the first in recent years from eastern India on aetiology and antimicrobial resistance in neonatal sepsis. Two areas of concern were the emergence of non fermenting Gram negative bacilli as causative organisms and the alarming degree of antibiotic resistance observed for commonly used antibiotics.