CAUSATIVE BACTERIA AND ANTIBIOTIC RESISTANCE IN NEONATAL SEPSIS

Shahzad Najeeb, Saima Gillani, Rifayyat Ullah, Anees ur Rehman

Abstract


Background: Neonatal sepsis is characterised by bacteraemia and clinical symptoms caused by
microorganisms and their toxic products. Gram negative bacteria are the commonest causes of neonatal
Sepsis. The resistance to the commonly used antibiotics is alarmingly high. The major reason for
emerging resistance against antibiotics is that doctors often do not take blood cultures before starting
antibiotics. We have carried out this study to find out various bacteria causing neonatal sepsis and their
susceptibility to antibiotics for better management of neonatal sepsis. Methods: A total of 130 neonates
with sepsis who were found to be blood culture positive were taken in this study. Culture/sensitivity
was done, isolated organisms identified and their sensitivity/resistance was noted against different
antibiotics. Data were arranged in terms of frequencies and percentage. Results: Out of 130 culture
proven cases of neonatal sepsis, gram negative bacteria were found in 71 (54.6%) cases and gram
positive bacteria in 59 (45.4%) cases. Staphylococcus aureus was the most common bacteria found in
35 (26.9%) cases followed by Escherichia coli in 30 (23.1%) cases. Acinetobacter species,
Staphylococcus epidermidis, Klebseila, Streptococci, Enterobacter cloacae and Morexella species were
found in 17 (13.1%), 17 (13.1%), 13 (10%), 7 (5.4%), 6 (4.6%), and 5 (3.8%) cases respectively. In
most of the cases causative organisms were found to be resistant to commonly used antibiotics like
ampicillin, amoxicillin, cefotaxime, and ceftriaxone (77.7%, 81.5%, 63.1%, and 66.9% respectively).
There was comparatively less (56.9%) resistance to ceftazidime. Gentamicin had resistance in 55.1%
cases, while amikacin and tobramycin had relatively less resistance (17.4% and 34.8% cases
respectively). Quinolones and imipenem had relatively less resistance. Vancomycin was found to be
effective in 100% cases of Staphylococcus group. Conclusion: Staphylococcus aureus are the most
common gram positive bacteria and Escherichia coli are the most common gram negative bacteria
causing neonatal sepsis. Resistance to commonly used antibiotics is alarmingly increasing. Continued
surveillance is mandatory to assess the resistance pattern at a certain level.
Keywords: Neonatal sepsis, bacterial isolates, Antibiotic susceptibility, Drug resistance, gram-positive,
gram-negative

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