Study of Microorganisms Causing Neonatal Sepsis in a Tertiary Care Hospital and their Antimicrobial Susceptibility Pattern (original) (raw)
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Neonatal septicemia: Blood culture bacterial isolates and their antimicrobial susceptibility pattern
IP innovative publication pvt. ltd, 2019
Introduction: Neonatal septicemia is defined as “a clinical syndrome of bacteremia with systemic signs and symptoms of infection in the first four weeks of life”. Blood culture is the gold standard method for diagnosis of septicemia. Isolation of organism in blood culture and its antimicrobial sensitivity pattern carries a great role. Aim: To provide prevalence and antimicrobial susceptibility pattern of bacteria isolated from suspected cases of neonatal septicemia at a tertiary care hospital, Valsad. Materials and Mathods: Retrospective study is conducted at a tertiary care hospital, Valsad from January 2017 to June 2018. Processing of blood culture samples, Isolation and identification of bacteria were done using standard microbiology techniques. Antimicrobial susceptibility testing was performed using modified Kirby-Bauer disk diffusion method as per Clinical laboratory Standard Institute guideline. ATCC E. coli 25922, ATCC S. aureus 25923, ATCC P. aeruginosa 27853 were used as standard strains. Results: Out of 452 blood cultures, organisms were isolated in 127(28.09%). Commonly isolated bacteria are Coagulase Negative Staphylococci (42.52%) followed by Klebsiella spp. (18.11%), Acinetobacter spp. (15.75%), Enterococcus spp. (9.45%) and others (Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa). Coagulase Negative Staphylococci strains have highest sensitivity to Vancomycin (100%), Linezolid (100%), Teicoplanin (100%), followed by Chloramphenicol (92.6%), Levofloxacin (90.7%), Cefoxitin (83.3%), and Tetracycline (77.8%). 16.7% isolates were Methicillin Resistant Staphylococci (MRS). Klebsiella spp. strain have highest sensitivity to Meropenem (73.9%), Imipenem (73.9%) and Amikacin (69.6%) followed by Chloramphenicol (65.2%), Tetracycline (60.9%) and Piperacillin Tazobactum (52.2%). 78.3% strains were Extended spectrum Beta-Lactamase (ESBL) producers. Conclusion: Antimicrobial resistances are growing among bacteria and it differs according to different areas. So, proper surveillance system should be established to guide antimicrobial policy at local level.
Bacteriological profile and antibiogram of neonatal septicemia in a tertiary care hospital
Innovative publication, 2016
Background: Neonatal sepsis is a clinical syndrome which is characterised by signs and symptoms of infection which may or may not be accompanied by bacteraemia within the first month of life. The bacteriological profile of neonatal sepsis is under constant change with the advances in the diagnosis and treatment. Blood culture is still the mainstay of investigation of potential sepsis in spite of the recent advances in molecular diagnosis of fungal and bacterial sepsis. Most common bacterial organisms responsible for neonatal septicaemia in developing countries like Bangladesh, India, Nigeria, Pakistan, are Klebsiella, Escherichia coli, Enterobacter etc. The present study was undertaken to describe the spectrum of the isolates in cases of neonatal septicaemia, and their antimicrobial susceptibility pattern. The study was carried out over a one year period. Method: A total of 357 suspected patients of neonatal septicaemia were included in the study. Blood samples were collected with aseptic precautions preferably prior to the initiation of empiric antibiotic therapy. The bottles were incubated aerobically at 37 0 C for 7 days and subcultured on blood agar and Mac Conkey agar. If growth appeared the isolates were processed as per standard microbiological techniques and the isolates were identified. Antibiotic sensitivity testing was performed on Mueller‑Hinton agar plates by modified Kirby‑Bauer disk diffusion method as per Clinical Laboratory Standard Institute guidelines. Results: Of the 357 samples studied, growth was observed in 154 samples. Gram positive organisms constituted 37.66% and gram negative bacilli constituted 62.34% of the isolates. The predominant pathogens isolated were Klebsiella species, Coagulase Negative Staphylococci, Staphylococcus aureus followed by Non fermenting gram negative bacilli. 71.43% of the Staphylococcus aureus isolates were found to be methicillin resistant.96.05% of the Enterobacteriaceae were found to be Extended Spectrum Beta Lactamase (ESBL) producers. 33.33% of the Pseudomonas isolates were found to be metallo-beta-lactamase (MBL) producers. Conclusion: This study shows that Klebsiella species, Coagulase Negative Staphylococci, Staphylococcus aureus and Non-fermenting gram negative bacilli were the commonest organisms associated with Neonatal sepsis. An alarmingly high rate of MRSA and ESBL producers was observed. This study stresses that antimicrobial resistance is a universal problem and it stresses the need for surveillance.
Antimicrobial resistance of bacterial pathogens in a Neonatal Intensive Care Unit
Bangabandhu Sheikh Mujib Medical University Journal, 2018
With the improvement of health care facilities and development of public awareness, neonatal mortality rate decreased significantly in Bangladesh from 36.8/1,000 live birth in year 2004 to 20/1,000 live birth in year 2015. 1 However, neonatal sepsis is, still, responsible for 30-50% of total neonatal deaths each year. 2 Globally, around 20% of neonates suffer from sepsis. 3 Since the aim of empirical therapy is to target the infectious microorganism(s), it is essential for every neonatal unit to survey the profile of causative microorganism and their susceptibility in order to ensure effective antimicrobial treatment. 3, 4 The pathogens causing neonatal sepsis varies overtime and places. 3, 4 Group B Streptococcus and E. coli still contribute to 70-75% of cases of neonatal septicemia in the North America and Europe. 4, 5 Whereas, Gram negative microorganisms remain the major cause of neonatal sepsis, particularly early onset sepsis in most of the developing countries. 4-10 Due to inappropriate use of antibiotics which is often seen in some developing countries, resistant microorganisms can grow in the community. 11-14 So, periodic surveillances are essential to identify antibiotic sensitivity pattern of the common pathogens. 15 Materials and Methods The study was conducted retrospectively from January 2012 and June 2016. All the cases of positive cultures (n=78) were included in the study and skin commensals, contaminates and fungal pathogens were excluded. After collection of the sample (2-3 mL of blood for culture, culture of tip of endotrachial tube, culture of aspirate from endotrachial tube) with all aseptic precaution, culture bottles were transported immediately to the Microbiology Laboratory and were processed as per standard microbiological techniques and the isolates were identified. All positive culture reports were checked, verified and analyzed. The sensitivity and resistance pattern of the various antibiotics against the isolated pathogens were also noted. The obtained data were statistically analyzed using Fisher's exact test using an r × c exact contingency table. We also used Statistical Package for Social Sciences (SPSS) version 16 for data analysis.
Microbiological Profile of Neonatal Sepsis at a Maternity Hospital in Omdurman, Sudan
Sudan Journal of Medical Sciences
Background: Neonatal sepsis is a clinical syndrome characterized by systemic signs of infection and accompanied by bacteremia in the first month of life. It is a major cause of morbidity and mortality in neonatal period. The study was conducted to determine microbiological profile and antibiogram of neonatal sepsis at Omdurman Maternity Hospital. Methods: This was a cross-sectional hospital-based study involving 202 neonatal blood cultures at Omdurman Maternity Hospital during the period from April 2017 to April 2018. Specimens were cultured in Brain Heart Infusion broth followed by subculture of isolates on blood agar, MacConkey agar, and Chocolate agar and incubated aerobically at 37ºC for 24 h. The isolates were tested for their susceptibility to antimicrobial agents using the Kirby Bauer disc diffusion method. Results: Of 202 positive blood cultures, 130 cases (64.4%) were early onset and 72 cases (35.6%) were recorded for late onset sepsis. Gram-negative pathogens approaching (123, 60.9%). Staphylococcus aureus was the most common organism in both groups of neonatal sepsis being isolated from (71, 35.7%), followed by Klebsiella pneumoniae (43, 21.2%). Gram-negative organisms were sensitive to Imepenem (97.3%) and Meropenem (80.5%) and resistant to third-generation Cephalosporins (65.3%) and Amoxicillin/Clavulanic acid (91.4%). Gram-positive organisms were resistant to Cefotaxime (75%), Amoxicillin/Clavulanic acid (65.4%), and Clindamycin (68.2%); 91.6% of gram-positive isolates were sensitive to Vancomycin. Conclusion: Gram-negative pathogens took the major spectrum of isolates. Klebsiella pneumoniae (21.2%) was the most frequent gram-negative organism. Methicillinresistant Staphylococcus aureus (MRSA) (33.7%) was the most common isolate. Most of the isolates were multidrug resistant. The best choice for treatment is Vancomycin (8.4%) and Imepenem (2.7%) for gram-positive and gram-negative, respectively. Adherence to antibiotic policy, antimicrobial surveillance, and policy updating is necessary.
THE PROFESSIONAL MEDICAL JOURNAL, 2017
ORIGINAL PROF-3914 ABSTRACT… Introduction: Neonatal sepsis is a systemic condition characterized by bacteremia that occurs in the first month of life. It is a fatal condition and need to be treated promptly. Bacterial isolates include both gram positive and negative bacteria and the cure of condition is highly dependent on antimicrobial drug sensitivity and resistant patterns. It is there for utmost important to known commonly occurring bacteria in neonatal septic states and their drug sensitivity patterns. Objectives: To determine the frequency of the bacterial isolates in blood and their sensitivity patterns to commonly used antibiotics in neonatal sepsis. Setting: Neonatal intensive care unit(NICU), Department of Shifa International Hospital. (SIH), Islamabad. Study Design: Cross sectional. Duration: This study was conducted between 6 1 st June 2013 to 30 th November 2013. Subject and Methods: A total of 180 neonates, admitted in NICU with evidence of clinical sepsis i.e. with signs and symptoms suggestive of septicemia (fever, lethargy, reluctance to feed, seizures, and irritability) were included in this study. The samples for blood cultures were taken. Identification of bacterial isolates was carried out by the standard bacteriological techniques, which include gram staining and bacterial cultures and antimicrobial sensitivity patterns which was performed by modified Kirby and Bauer disc diffuse method as per CLSI (Clinical and Laboratory StandardsInstitute)guidelines.A predesigned Performa was filled. Results: Culture revealed bacterial growth in 7.2% samples. Gram negative organisms were observed in 6.67% and only 1 were gram positive. In this study, 50% and 100% of E-coli were sensitive to ampicillin, meropenem and amikacin, gentamycin respectively. Sixty to 100% of pseudomonas was sensitive to ceftazidime, tazobactum, meropenem and 100% of enterococcus was sensitive to ampicillin and vancomycin. Conclusion: Antimicrobial drug resistance and constantly changing resistance patterns is emerging issues in various groups of infections and septic states, especially for routinely used antibiotics as found in our study. Thus by prescribing rational use of antimicrobial as per bactriogram, It'll be easier totreat sepsis effectively and economically and reduce the mortality and morbidity related to neonatal sepsis.
The bacterial profile of neonatal septicaemia in a rural hospital in south India
2010
Introduction: Neonatal sepsis is the most common cause for neonatal deaths in the NICU. Newborn blood culture and sensitivity testing are important tools in the diagnosis of neonatal sepsis and in the institution of early antibiotic treatment. Material and Methods: This study was conducted by analyzing the blood cultures and the sensitivity reports of 100 newborns who were admitted to the NICU over a period preceding one year. Results: Of the 100 newborns, 32 (32%) showed positive blood culture reports. Out of the 32 positive blood cultures, 19 (59.4%) showed positivity for Coagulase negative Staphylococcus, 7 (21.9%) showed positivity for Staphylococcus aureus, 3 (9.4%) showed positivity for Pseudomonas aeruginosa, 1 (3.1%) showed positivity for Enterococci, 1 (3.1%) showed positivity for Micrococci and 1 (3.1%) showed positivity for Flavobacteria. Overall, most of the neonatal sepsis was caused by Coagulase negative staphylococcus. The sensitivity pattern of the first line of antibiotics was as follows; out of the 19 Coagulase negative staphylococcus strains, 13 (68.42%) showed sensitivity to amikacin and ciprofloxacin, 15 (78.95%) to sparfloxacin, 9 (47.37%) to erythromycin, 10 (52.63%) to azithromycin, 12 (63.16%) to gentamicin and cephalexin and 5 (26.32%) to penicillin. Out of the 7 Staphylococcus aureus strains, 6 (85.71%) showed sensitivity to amikacin, 5 (71.43%) to erythromycin, 4 (57.14%) to sparfloxacin and ciprofloxacin, 3 (42.86%) to azithromycin and cephalexin and 1(14.29%) to penicillin and gentamicin. Out of the 3 Pseudomonas aeruginosa strains, 2 (66.7%) were sensitive to ciprofloxacin and amikacin and 1 (33.3%) was sensitive to to sparfloxacin, azithromycin and gentamicin. Enterococci showed sensitivity to sparfloxacin, cephalexin, and ciprofloxacin. Flavobacteria showed sensitivity to gentamicin, erythromycin, ciprofloxacin, sparfloxacin and amikacin. Their resistance patterns were also studied. Conclusion: Coagulase negative staphylococcus is the most common cause for neonatal sepsis in the NICU. Most of the organisms were sensitive to Amikacin.
Background: Bacterial blood stream infection is an important cause of morbidity and mortality in neonates. This study was undertaken to identify the bacterial isolates from suspected neonatal septicemia patients and to understand their antimicrobial susceptibility pattern in Chattogram. Materials and methods: A cross-sectional descriptive type of study was done for a period of two years from January 2022 to December 2023. Blood samples from 340 neonates with clinically suspected septicemia were taken for automated culture and susceptibility test was conducted in Bacteriology Laboratory of IbneSina, Chattogram. The samples were collected and processed following standard microbiological techniques and an antibiotic susceptibility test was done on pure culture isolates using disc-diffusion method for the commonly used antibiotics. The data were analyzed by using SPSS version 20 and the results were summarized by using tables and graphs. Results: Out of 340 blood culture done, 62 (18.24%) were positive. Among them 61.3% were of early onset sepsis. The predominant bacteria isolated was Klebsiella spp. 27 (43.6%) followed by Coagulase negative staphylococci 12 (19.4%), Salmonella typhi 10 (16.1%), E. coli 6 (9.6%) and Pseudomonas 5 (8.0%). Antibiotic susceptibility tests showed that the most sensitive antibiotics to Gram-negative organisms wereImipenem (81-100%), Tazobactam-Piperacillin (74-100%), Amikacin (67-90%), Ceftriaxone (60-100%) and Levofloxacin (63-80%). Maximum resistance among Gram-negative organisms were seen in Ampicillin (60-100%), Cotrimoxazole (60-100%) and Cefixime (30-80%). Among Gram-positive organisms, all strains (100%) were sensitive to Linezolid and Vancomycin. Other alternates with good sensitivity were Amikacin (92%), Imipenem (83%), Ceftriaxone (83%) and Levofloxacin (75%). While maximum resistance was seen to Ampicillin (83%), Amoxiclav (75%), Cefixime (75%) and Ciprofloxacin (75%). Conclusions: In the present study, most of the pathogens isolated from blood cultures were Gram negative and they showed high resistance to commonly used antibiotics. Therefore, rational use of antibiotics after sensitivity testing should be practiced.
Neonatal sepsis is one of the most important causes of infant mortality and morbidity. In spite of availability of broad spectrum antibiotics, treating sepsis has become a challenge due to emergence of resistant strains from time to time. The present study is aimed at to isolate the organisms causing sepsis in neonates and their antibiotic susceptibility patterns. From April 2013 to June 2014, 167 blood samples were collected from clinically diagnosed cases of neonatal sepsis. The samples were conventionally processed and the isolated organisms and their antibiotic susceptibility pattern were analysed. There are 38 (22.75%) samples which are culture positive out of 167 samples. There are almost equal culture positivity in early onset sepsis (23.64%) and late onset sepsis (23.32%). The most common isolated organism is Coagulase Negative Staphylococci. All isolates are resistant to penicillin, amoxicillin and third generation cephalosporins. All isolates except pseudomonas are susceptible to Piperacillin/Tazobactum and all Gram positive isolates are susceptible to Vancomycin. As the most of the isolates are multidrug resistant, it is essential to do regular studies to know the changing trends in causing organisms and their susceptibility patterns which helps not only in effective management of sepsis but also in choosing empirical antibiotic of choice.
IP Innovative Publication Pvt. Ltd., 2019
Introduction: Neonatal sepsis is a major cause of neonatal mortality, the clinical outcome of which depends on early diagnosis and initiation of appropriate antibiotics. The emergence of multi-drug resistant strains has limited the choice of available antibiotics. Thus, antibiotic resistance pattern of pathogens iscritical for both therapy and infection control. Objective: To determine the etiological agents of neonatal sepsis and their antibiotic resistance pattern. Materials and Methods: In this study, all neonates with suspected sepsis, admitted to neonatal intensive care unit during January to December, 2014 were included. Aerobic blood culture was done using BACTEC FX system. Identification and antibiotic susceptibility testing of isolates from positive cultures was carried out. Results: Out of 522 neonates who developed clinical sepsis, 64 grew pathogens on blood culture. The most common organisms were coagulase negative Staphylococcus species (CONS)(32.8%), Klebsiella pneumoniae (18.7%), Escherichia coli (9.4%), Enterococcus faecalis (7.8%) and Candida species (7.8%). The gram negative isolates showed high resistance to ampicillin (90%), gentamicin (70%), ceftriaxone (66.7%), cotrimoxazole (56.7%), amikacin (53.3%) and ciprofloxacin (43.3%). In contrast, imipenem (16.7%), piperacillin-tazobactam (26.7%) and cefepime-tazobactam (0%) were effective with lower resistance rates. A large majority of the Enterobactericeae isolates (66.7%) were extended spectrum beta-lactamase producers. Among the gram positive isolates, resistance to penicillin, erythromycin and ciprofloxacin were 93.1%, 62.1%and 51.7% respectively. These strains showed uniform sensitivity to vancomycin, teicoplanin and linezolid. Conclusion: While CONS were the predominant isolate, gram negative bacilli and Enterococcus sp have shown high resistance to commonly used antibiotics. Low resistance was observed with Cefepime-tazobactam, imipenem (for gram-negative isolates) and vancomycin, teicoplanin and linezolid (for gram-positive isolates) in our study. Keywords: Neonatal sepsis, Bacteraemia, Antibiotic resistance, Blood culture.
2020
Neonatal sepsis is a major healthcare burden responsible for high rates of neonatal mortality. Due to its non-specific signs and symptoms and delay in identification, it poses a great challenge to the clinician in ruling out sepsis at an early stage. The present study was undertaken to identify the recent trends in bacteriological profile associated with neonatal sepsis, their antibiotic resistance pattern and the major risk factors associated with neonatal sepsis. In this cross-sectional study, blood cultures were performed from suspected cases of neonatal sepsis. Growth was identified by standard microbiological techniques and antibiotic susceptibility testing was carried out by Kirby-Bauer disk diffusion method. MRSA (Methicillin Resistant Staphylococcus aureus) and ESBL (Extended Spectrum β-Lactamase) or AmpC β-Lactamase and carbapenemase production was detected phenotypically following CLSI (Clinical and Laboratory Standard Institute) guidelines. Out of 812 blood samples collec...