Bacterial Etiology of Neonatal Sepsis, Antibiotic Susceptibility Profile, and Associated Factors at Burdwan Medical College, Burdwan, West Bengal, India

Abstract

Objective Neonatal sepsis remains to be a major cause of neonatal mortality and morbidity in developing countries like India. This study was aimed to identify the bacterial isolates and study antimicrobial profile among admitted babies with neonatal sepsis. Methods A cross-sectional retrospective study was conducted in the sick neonatal wards and neonatal intensive care unit of Burdwan Medical College from March 2017 to February 2018. A total of 299 neonates suspected of neonatal sepsis was evaluated. Diagnosis of neonatal sepsis was made through positive blood culture. Positive samples were subcultured on specific media like blood, chocolate agar, nutrient, Muller-Hinton agar, and MacConkey plates, and the organisms were identified by gram staining and biochemical reactions. Antibiotic susceptibility was tested by Kirby-Bauer disc diffusion method. Results Overall, 118 blood cultures out of 299 patients (39.46%) were bacteria-positive. Of these, 31.3% cases had early-onset septicemia (EOS), while 68.6% had late-onset septicemia (LOS). The prevalence of sepsis was higher in males (55.9%), preterm babies (58.47%), and low birth weight neonates (37.29%). The highest bacterial strains isolated were Klebsiella spp. (33.8%) followed by Staphylococcus aureus (25.8%), Escherichia coli (22.8%), coagulase-negative Staphylococcus (12.5%), Pseudomonas spp. (2.5%), Enterococcus spp. (1.6%), Acinetobacter spp. (0.8%), and Burkholderia spp. (0.8%). Resistance is high among the gram-negative bacteria, like Enterobacter and Pseudomonas, for piperacillin-tazobactam and cephalosporins but they are mostly sensitive to meropenem, colistin, and levofloxacin. Gram-positive bacteria, like S. aureus, are mostly resistant to amoxicillin-clavulanic acid but highly sensitive to linezolid, vancomycin, azithromycin, and teicoplanin. Conclusion K. spp. and S. aureus are the most common isolates in our study. The level of resistance among the organisms toward conventional antibiotics like amoxicillin, cephalosporins, and piperacillin-tazobactum is alarmingly high. This warrants formulation of a hospital-specific guideline for antibiotic use and periodic review of the same.