Introduction: Neonatal Mortality Rate (NMR) is one of the indicators of health status of a nation and neonatal sepsis is one of the commonest causes of NMR contributing to 19% of all neonatal deaths in India. Neonatal sepsis occurs in two distinct patterns based on age of onset early onset and late onset septicemia. All over India, there is a gradually increasing trend of multi-drug resistant (MDR) pathogens in neonatal intensive care units (NICU) and special newborn care units (SNCUs) in tertiary care hospitals.
Aims: To determine the changing trend in the bacteriological profile of neonatal septicemia and their antibiotic susceptibility pattern (AST).
Materials & Methods: It is a retrospective study conducted on total 452 blood culture samples collected from SNCU over 1 year period in tertiary care government hospital. Organisms were identified by the standard protocol and their antimicrobial susceptibility testing was determined as per latest CLSI guidelines.
Results: out of 452 blood culture of neonatal septicemia patients, 138 cases (30.53%) were culture positive Among positive culture reports gram negative isolates were found more frequent 85/138 (61.59%). Most common isolated gram negative organism was Klebsiella spp. 55/138 (39.85%) followed by Citrobacter spp. 23/138 (16.66%). Most common isolated gram positive organism was Staphylococcus aureus 25/138 (18.11%) followed by Coagulase Negative Staphylococcus (CONS) (8.69%). Among gram negative isolates most sensitive antimicrobial was Imipenem (87.6%) followed by Levofloxacin (87.4%) and Piperacillin + Tazobactam (46%) and resistant to, Cotrimoxazole, Amoxicillin + clavulanate and 3rd generation Cephalosporin.
Conclusion: Klebsiella spp. is the predominant organism of neonatal sepsis in the Indian subcontinent, although significant rise in proportion of Citrobacter spp. is occurring. High resistance to cephalosporins is a cause of concern, as they are one of the most common prescribed antibiotic groups.
Keywords: Neonatal septicemia, Citrobacter emerging, Bacteriological profile
