CAUSATIVE BACTERIA AND ANTIBIOTIC RESISTANCE IN NEONATAL SEPSIS

Authors

  • Shahzad Najeeb
  • Saima Gillani
  • Rifayyat Ullah
  • Anees ur Rehman

Abstract

Background: Neonatal sepsis is characterised by bacteraemia and clinical symptoms caused bymicroorganisms and their toxic products. Gram negative bacteria are the commonest causes of neonatalSepsis. The resistance to the commonly used antibiotics is alarmingly high. The major reason foremerging resistance against antibiotics is that doctors often do not take blood cultures before startingantibiotics. We have carried out this study to find out various bacteria causing neonatal sepsis and theirsusceptibility to antibiotics for better management of neonatal sepsis. Methods: A total of 130 neonateswith sepsis who were found to be blood culture positive were taken in this study. Culture/sensitivitywas done, isolated organisms identified and their sensitivity/resistance was noted against differentantibiotics. Data were arranged in terms of frequencies and percentage. Results: Out of 130 cultureproven cases of neonatal sepsis, gram negative bacteria were found in 71 (54.6%) cases and grampositive bacteria in 59 (45.4%) cases. Staphylococcus aureus was the most common bacteria found in35 (26.9%) cases followed by Escherichia coli in 30 (23.1%) cases. Acinetobacter species,Staphylococcus epidermidis, Klebseila, Streptococci, Enterobacter cloacae and Morexella species werefound in 17 (13.1%), 17 (13.1%), 13 (10%), 7 (5.4%), 6 (4.6%), and 5 (3.8%) cases respectively. Inmost of the cases causative organisms were found to be resistant to commonly used antibiotics likeampicillin, amoxicillin, cefotaxime, and ceftriaxone (77.7%, 81.5%, 63.1%, and 66.9% respectively).There was comparatively less (56.9%) resistance to ceftazidime. Gentamicin had resistance in 55.1%cases, while amikacin and tobramycin had relatively less resistance (17.4% and 34.8% casesrespectively). Quinolones and imipenem had relatively less resistance. Vancomycin was found to beeffective in 100% cases of Staphylococcus group. Conclusion: Staphylococcus aureus are the mostcommon gram positive bacteria and Escherichia coli are the most common gram negative bacteriacausing neonatal sepsis. Resistance to commonly used antibiotics is alarmingly increasing. Continuedsurveillance is mandatory to assess the resistance pattern at a certain level.Keywords: Neonatal sepsis, bacterial isolates, Antibiotic susceptibility, Drug resistance, gram-positive,gram-negative

References

Waheed M, Laeeq A, Maqbool S. The etiology of neonatal sepsis

and patterns of antibiotic resistance. J Coll Physicians Surg Pak

;13:449–52.

Vergnano S, Sharland M, Kazembe P, Mwansambo C, Heath PT.

Neonatal sepsis: an international perspective. Arch Dis Child

Fetal Neonatal Ed 2005;90(3):F220–4.

Adejuyigbe EA, Adeodu OO, Ako-Nai KA, Taiwo O, Owa JA.

Septicaemia in high risk neonates at a teaching hospital in Ile-Ife,

Nigeria. East Afr Med J 2001;78:540–3.

Osrin D, Vergnano S, Costello A. Serious bacterial infections in

newborn infants in developing countries. Curr Opin Infect Dis

;17:217–24.

Ellabib MS, Ordonez A, Ramali A, Walli A, Benayad T, Shebrlo

H. Changing pattern of neonatal bacteremia. Microbiology and

antibiotic resistance. Saudi Med J 2004;25:1951–6.

Yalaz M, Cetin H, Akisu M, Aydemir S, Tunger A, Kültürsay N.

Neonatal nosocomial sepsis in a level-III NICU: evaluation of the

causative agents and antimicrobial susceptibilities. Turk J Pediatr

;48:13–8.

Newton O, English M. Young infant sepsis: aetiology, antibiotic

susceptibility and clinical signs. Trans R Soc Trop Med Hyg

;101:959–66.

Zaidi AK, Thaver D, Ali SA, Khan TA. Pathogens associated

with sepsis in newborns and young infants in developing

countries. Pediatr Infect Dis J 2009;28:10–8.

Aftab R, Iqbal I. Bacteriological agents of neonatal sepsis in

NICU at Nishtar Hospital Multan. J Coll Physicians Surg Pak

;16:216–9.

Anah MU, Udo JJ, Ochigbo SO, Abia-Bassesy LN. Neonatal

septicaemia in Calabar, Nigeria. Trop Doct 2008;38:126–8.

Rubin LG, Sanchez PJ, Siegel J, Levine G, Saiman L, Jarvis WR.

Evaluation and treatment of neonates with suspected sepsis: a

survey of neonatologists practices. J Pediatr 2002;110:e42.

Buttery JP. Blood cultures in newborn and children: optimizing

an everyday test. Arch Dis Child Fetal Neonatal Ed

;87:F25–8.

Shaw CK, Shaw P, Thapalial A. Neonatal sepsis bacterial isolates

antibiotics susceptibility patterns at a NICU in a tertiary care

hospital in western Nepal: A retrospective analysis. Kathmandu

Uni Med J 2007;5(2):153–60.

Moreno MT, Vargas S, Poveda R, Sáez-Llorens X. Neonatal

sepsis and meningitis in a developing Latin American country.

Pediatr Infect Dis J 1994;13:516–20.

Lim NL, Wong YH, Boo NY, Kasim MS, Chor CY.

Bacteraemic infections in a neonatal intensive care unit: a nine

months survey. Med J Malaysia 1995;50:59–63.

Bhutta ZA. Epidemiology of neonatal sepsis in Pakistan. An

analysis of available evidence and implication for care. J Coll

Physicians Surg Pak 1996;6(1):12.

Waseem R, Khan M, Izhar TS. Neonatal sepsis. Professional

Med J 2005;12:451–6.

Karlowicz MG, Buescher ES, Surka AE. Fulminant late onset

sepsis in a neonatal intensive care unit, 1988–1997 and impact of

avoiding empirical vancomycin therapy. J Pediatr

;106:1387–90.

The WHO young infants study group. Bacterial etiology of serious

infections in young infants in developing countries: Results of a

multicenter study. Pediatr Infect Dis J 1999;18:S17–22.

Bindayna KM, Jamsheer A, Farid E, Botta GA. Neonatal Sepsis

–2001: Prevalent bacterial agents and antimicrobial

susceptibilities in Bahrain. Med Prince Pract 2006;15:131–6.

Awoniyi DO, Udo SJ, Oguntibeju. An epidemiological survey of

neonatal sepsis in a hospital in western Nigeria. Afr J Microbiol

;3:385–9.

Aftab R, Iqbal I. Bacteriological agents of neonatal sepsis in

NICU at Nishtar Hospital, Multan. J Coll Physicians Surg Pak

;16:216–9.

Downloads

Published

2012-12-01

Most read articles by the same author(s)

1 2 > >>