Pattern and antimicrobial susceptibility of organisms causing blood stream infection in a Neonatal Intensive Care Unit (NICU) from India

Abstract

Background: Globally infections are the single most common cause of neonatal deaths. A report from India (National Neonatal-Perinatal Database - NNPD: 2002-03) showed incidence of sepsis was 30/1000 live births (LB). Pattern and antimicrobial susceptibility of organisms have kept on changing in the NICU. Objective: To identify common bacterial pathogens associated with neonatal sepsis in a tertiary care NICU and to determine their antibiotic susceptibility pattern. Design/Methods: Prospective descriptive study. Blood culture reports of culture positive neonatal sepsis admitted to Level III NICU in South India during January 2011-June 2012 were analyzed. Demographic data of the babies was collected. Results: Total 1924 blood cultures were done for in total 1924 blood cultures were done for babies with suspected clinical sepsis. The yield rate was 9.3% (n=179/1924). The incidence of culture proven sepsis was 24/1000 live births. Of all, 82% (n=148) were Gram-negative organism, 11% (n=20) were Gram-positive organism and 7 % (n=11) were fungal organism. Over all, Klebsiella pneumoniae was the most common organism (45%) in both early onset sepsis (EOS) and late onset sepsis (LOS) followed by Acinetobacter species. The overall drug resistance to first and second line antibiotics like Ampicillin (100%), Gentamicin (91%), Amikacin (47%) and Piperacillin plus Tazobactum (45%) were high. Conclusions: The incidence of sepsis was similar to NNPD data 2002-2003, not changed much since a decade. Acinetobacter species are important emerging and drug resistant organism in newborn sepsis. It is alarming to note that the drug resistance among organisms causing both early and late onset neonatal sepsis.