Bacteriological profile of sepsis outbreak in the NICU of a tertiary care hospital in western Nepal

Abstract

Introduction: Neonatal sepsis is a serious problem for the neonates who are admitted to the intensive care and outbreak of sepsis is not uncommon. This paper aims to describe a sepsis outbreak as a result of too many admissions, overcrowding of babies with limited working staffs in the unit and compares microorganisms with their antibiogram in newborn and environmental samples. Materials and Methods: Prospective observational study from 1st April-15th August 2011 in Neonatal Intensive Care unit of Manipal Teaching Hospital, Pokhara and included all babies admitted for sepsis. Results: There were 103 (57.22%) episodes of neonatal septicemia (Term =47.8%; Preterm = 84.8% p<0.001), 14/20, 70% of whom died of sepsis. 47.52% had early onset sepsis and 52.42% had late onset sepsis and 39.8% had nosocomial infection. The predominant isolates in newborn (NB) were E. coli, staphylococcus aureus and Klebsiella pneumonia and in environmental sample it was Klebsiella pneumonia and Staphylococcus. aureus. Imipenem, Vancomycin, Netilmycin, Tobramycin and chloramphenicol were sensitive (S-100%) while Carbenicillin and Piperacillin, Ampicillin, most cephalosporins, Penicillin were resistant (R-100%) to organisms in newborn and environmental samples. Other S-100% antibiotics for newborn were Ceftazidime, Ciprofloxacin and Gentamycin while S-100% for environmental sample isolates were Cephoperazone, Cloxacillin, Cefuroxime and Tetracycline. Other (R-100%) antibiotics for newborn were Amoxicillin and Amoxyclav and for environmental sample were Gentamycin and Erythromycin. Conclusions: Sepsis is a severe problem for neonates. Periodic evaluation of bacterial antibiotic susceptibility and judicious selection of antibiotics is necessary to reduce the resurgence of multidrug resistant strains.