Clinical Profile of Neonatal Sepsis With Reference to Antibiotic Resistance

Abstract

Introduction : Neonatal sepsis continues to be a major cause of morbidity and mortality in neonates. It is 30 per 1000 live births in India. The prevalence is more in preterm neonates. Objectives To describe the clinical and bacteriological spectrum in early onset sepsis and late onset sepsis. To describe the antibiotic resistance profile of bacteria causing early and late onset sepsis. To compare the risk factors and bacteriological spectrum in early onset and late onset sepsis. Setting:  NICU of civil hospital Ahmedabad Study period: June 2016 to December 2016 Design: retrospective cohort study Methods:  all neonate admitted in NICU of civil hospital Ahmedabad during the abovementioned period were assessed. Inclusion criteria: presence of one or more of established clinical features like , (fever/hypothermia, poor feeding, poor activity, respiratory distress/apneic spells, hepatospleenomegaly, vomitting, abdominal distension, seizures, signs of either respiratory or circulatory dysfunction evidenced by tachycardia/bradycardia, capillary refill time>3 seconds,, respiratory rate>60/minute, chest indrawing and/or grunting)along with >_2 of the following laboratory criteria(total blood leukocyte count<5000 or>15000, absolute neutrophil count(ANC)<500 cells/mm3or >1500 cells/mm3,C reactive protein (CRP)>0.6microgram/ml, positive blood culture). Information assessed in a proforma. Cases were divided into early onset sepsis(EOS) (presenting in the first 72 hours) and late onset sepsis(LOS) (presenting after 72 hours). All cases were started on antibiotics and upgraded or stopped based on culture and sensitivity. Cases were followed to discharge/death.