Changing Trends of Antimicrobial Resistance in Neonatal Sepsis: Experience from a Tertiary Care Hospital from West Bengal, India
Introduction: Sepsis is the second leading cause of neonatal mortality in India. Emergence of highly resistant microorganisms as an aetiology of neonatal sepsis is a matter of serious concern. Aim: To study the prevailing aetiological agents in neonatal sepsis and their antimicrobial susceptibi...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2021-07-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/15136/49015_CE[Ra1]_F[IK]_PF1(SS_OM)_PFA(SC_KM)_PN(KM).pdf |
| Summary: | Introduction: Sepsis is the second leading cause of neonatal
mortality in India. Emergence of highly resistant microorganisms
as an aetiology of neonatal sepsis is a matter of serious
concern.
Aim: To study the prevailing aetiological agents in neonatal
sepsis and their antimicrobial susceptibility pattern.
Materials and Methods: A prospective observational study
was performed in a tertiary care teaching hospital in neonatal
care units in North Bengal Medical College and Hospital, West
Bengal, India, over a period of two years from March 2017
to February 2019. All the neonates having clinical features
suggestive of sepsis were subjected to blood culture using
BacT/ALERT® PF Plus. Microbial identification and antibiotic
susceptibility testing was done by VITEK-2 automated systems.
Chi-square test was done using Epi info software version 7.1
and p-value <0.05 was considered significant.
Results: Out of 403 neonates investigated for suspected
sepsis, 156 (38.7%) were found to be culture positive. Klebsiella
pneumoniae was the most common organism isolated (n=90,
57.7%) followed by Staphylococcus aureus (n=24, 15.4%) and
Acinetobacter baumannii (n=10, 6.4%). Klebsiella pneumoniae
showed a very high degree of resistance to ampicillin,
amoxycillin-clavulenic acid (100% each), cefotaxime (93.4%),
ceftazidime (92.3%), gentamycin (94.5%) and tobramycin
(94.5%). High resistance of Staphylococcus aureus was seen
against ampicillin (100%), cloxacillin (62.5%), amoxicillinclavulenic acid (70.9%), and cefotaxime (79.2%). Few isolates
of Klebsiella pneumonia (6.6%), Acinetobacter baumannii
(60%) and Enterobacter cloacae (50%) were sensitive only to
colistin and tigecycline.
Conclusion: Most of the isolates showed very high degree
of resistance against first line of antibiotics recommended by
World Health Organisation (WHO) (ampicillin and gentamycin
or amikacin) for empirical treatment of neonatal sepsis.
Emergence of highly resistant organisms sensitive only
to colistin and tigecycline should be considered as an eye
opener. Strict adherence to sepsis prevention along with
regular surveillance of organisms and their sensitivity patterns
is the need of the hour to improve survival by contributing to
antibiotic stewardship. |
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| ISSN: | 2249-782X 0973-709X |