Neonatal Sepsis; Incidence and Microbiological Profile along with Antibiotic Sensitivity of Causative Microorganisms

Abstract

Objective: To find the incidence of neonatal sepsis, microorganisms involved and their antibiotic sensitivity
among neonates admitted with neonatal sepsis during the study period.
Study Design: Prospective observational study.
Place and Duration of Study: The study was carried out at neonatal intensive care unit (NICU) of combined
military Hospital (CMH), Kharian, Pakistan from January 2019 to December 2020.
Materials and Methods: After getting permission from Ethical Review Board of hospital, all the neonates who
were admitted in neonatal intensive care unit (NICU) of hospital with neonatal sepsis were included in subject
study. All the neonates with fever, irritability, difficulty in feeding, respiratory distress, fits, bulging fontanels,
jaundice, bleeding etc. were suspected as case of "Neonatal sepsis". Venous blood sample of neonates was
drawn under aseptic technique and collected in sterile BacT/ALERT (PF) blood collecting culture bottles and
sent to laboratory immediately for culture, sensitivity procedure and reporting.
Results: A total of 4892 neonates were admitted in neonatal intensive care unit from January 2019 to
December 2020. Out of these, 342 neonates were clinically diagnosed as cases of neonatal sepsis. Incidence of
neonatal sepsis was 6.99%, comprising 185 males (54.1%) and 157 females (45.9%). The age range was from 2
days to 88 days with a mean age 35.47+23.40 days. Staphylococcus aureus was found to be the most commonly
infectious microorganism (33.9%) followed by Candida species (18.5%), Klebsiella pneumoniae (14.5%) and
Coagulase negative Staphylococci (12.3%). Non-fermenting Gram negative bacteria were found to be infecting
26 (11.5%) out of the total positive cases (Acinetobacter baumannii complex 8.4%, Stenotrophomonas
maltophilia 3.1% and Pseudomonas aeruginosa 2.6%).
Conclusion: Staphylococcus aureus was the most prevalent organism found to be responsible for neonatal
sepsis with majority being resistant to Methicillin. Methicillin-resistant Staphylococcus aureus (MRSA) is a
100% percent sensitive to vancomycin and Teicoplanin. On the other hand, Gram Negative organisms have
shown promising sensitivity to Colistin.