Acinetobacter sepsis in newborns

Abstract

Objective: To evaluate the clinico-epidemiological profile of Acinetobacter sepsis in neonates.

Design: Retrospective study.

Setting: Level II Neonatal Care Unit.

Subjects: 79 neonates with blood culture positive for Acinetobacter.

Methods: Relevant information was collected on a predesigned proforma from the case records and analyzed for clinical and epidemiological characteristics.

Results: The incidence of Acinetobacter septicemia was 11.1/1000 live births. Fifty-five babies were hospital born, 24 were outborn. Out of these, 64.6% babies were born at term and 40.5% had a birth weight of 2500 g or more. A cluster of 53 cases was seen between May and September 1995. In cases with early onset sepsis (onset < 7 days of postnatal age), difficulty in breathing (n = 54), chest retraction (n = 35) and refusal to feed (n = 46) were seen more commonly as compared to late onset sepsis (p < 0.05). Complications observed included meningitis, bleeding manifestations and necrotising enterocolitis in three, six and five babies, respectively. The organism was sensitive to ciprofloxacin (96.2%), amikacin (92.4%) and gentamicin (87.3%). A response rate of 52.4% was observed with Ciprofloxacin in babies not responding to cefotaxime and amikacin combination. The overall mortality was 13.9%.

Conclusion: Nosocomial Acinetobacter sepsis may affect fullterm, appropriate for gestational age babies. Clinical presentation is indistinguishable from Gram negative septicemia. Life threatening complications can also occur. Ciprofloxacin may prove to be useful drug in resistant cases.