Susceptibility Pattern of Blood Stream Infections in Neonatal Sepsis: Striking Alarm in Era of Antibiotic Resistance

Abstract

Neonatal blood stream infections are significantly associated with increased morbidity and mortality in the recent years. In this study, we aim to determine the bacteriological profile and antibiotic susceptibility pattern of culture positive neonatal sepsis in the NICU of a tertiary teaching hospital in Kolkata. This retrospective study was conducted in the Department of Microbiology of a tertiary care teaching hospital in Kolkata between August, 2020 to July, 2021. All the neonates [both inborn / out born] admitted to NICU with the clinical diagnosis of sepsis during the specified period were screened for BSI. The blood was cultured in BACTAlert and analysed by VITEK 2. Out of 200 neonates with sepsis, 30 had culture positive sepsis of which 60% were Gram positive, rest were Gram negative. Staphylococcus aureus and Coagulase negative Staphylococcus (CoNS) were predominant (35.2%), Klebsiella was the predominant Gram negative organisms. Babies with birth weight ≤ 2 kg and gestational age 33 to 37 weeks were affected. Mortality was seen in 36.3% babies. Significant proportion of multidrug resistant isolates posed a great threat to neonatal survival. Hence modification of therapy based on anti-microbial surveillance pattern of the Institution with implementation of proper escalation and de-escalation of therapy is warranted. Keywords: antibiotic resistance, blood stream infections, culture positive sepsis