NEONATAL SEPSIS: CAUSATIVE BACTERIA AND THEIR RESISTANCE TO ANTIBIOTICS
Abstract
Background: Neonatal sepsis is one of the major causes of neonatal morbidity and mortality,particularly in developing countries. The objective of this study was to determine the causative bacteriaand level of their resistance to commonly used antibiotics. Methods: This descriptive study was carriedout at Ayub Teaching Hospital, Abbottabad from April 2009 to January 2010. All neonates of eithergender admitted in neonatology unit with clinical sepsis and positive blood culture were included in thestudy. Neonatal period was defined as 28 days of life at term and up to 44 weeks of gestational age inpreterm babies. One hundred and thirty neonates of either gender were studied during the period. Bloodsample for culture was taken from a peripheral vein or an artery ensuring standard anti-septic measures.BACTEC technique was used for obtaining bacterial growth and drug sensitivity after incubation of24–48 hours. Second blood culture was also performed in few cases which were not showingimprovement after initial treatment. Results: Male to female ratio was 1.3:1. Early and late onset sepsiswas found in 29.2% and 70.8% respectively. Gram-negative bacteria were more frequent than grampositive bacteria with a frequency of 54.6% and 45.4% respectively. Gram-positive and gram-negativebacteria showed high resistance against commonly used antibiotics such as ampicillin, amoxicillin,cefotaxime, ceftriazone and gentamicin. Conclusion: Staph. aureus is the most common gram-positivebacterium and E. coli is the most common gram-negative bacterium causing neonatal sepsis. Grampositive and gram-negative bacteria are highly resistant against commonly used antibiotics such asampicillin, amoxicillin, cefotaxime, ceftriazone and gentamicin, and are relatively more sensitive to lesscommonly used drugs like amikacin and ceftazidime.Keywords: Neonatal sepsis, antibacterial resistance, gram-positive, gram-negativeReferences
Waheed M, Laeeq A, Maqbool S. The eitiology of neonatal
sepsis and patterns of antibiotic resistance. J Coll Physicians Surg
Pak 2003;13:449–52.
Zaidi AKM, Thaver D, Ali SA, Khan TA. Pathogens associated
with sepsis in newborns and young infants in developing
countries. Pediatr Infect Dis J 2009;28:S10–S18.
Sundaram V, Kumar P, Dutta S, Mukhopadhyay K, Ray P,
Gautam V, et al. Blood culture confirmed bacterial sepsis in
neonates in a North Indian tertiary care center: changes over the
last decade. Jpn J Infect Dis 2009;62:46–50.
Movahedian AH, Moniri R, Mosayebi Z. Bacterial culture of
neonatal sepsis. Iranian J Publ Health 2006;35:84–9.
Aletayeb SMH, Khosravi AD, Dehdashtian M, Kompani F,
Mortazavi SM and Aramesh MR. Identification of bacterial
agents and antimicrobial susceptibility of neonatal sepsis: a 54-
month study in a tertiary hospital. Afr J Microbiol Res
;5:528–31.
Rajaratnam JK, Marcus JR, Flaxman AD, Wang H, Rector AL,
Dwyer L, et al. Neonatal, postneonatal, childhood, and under-5
mortality for 187 countries, 1970–2010: a systematic analysis of
progress towards Millennium Development Goal 4. Lancet
;375:1988–2008.
Friberg IK, Bhutta ZA, Darmstadt GL, Bang A, Cousens S,
Baqui AH, et al. Comparing modelled predictions of neonatal
mortality impacts using LiST with observed results of
community-based intervention trials in South Asia. Int J of
Epidemiol 2010;39:i11–i20.
Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani
DG, et al. Global, regional, and national causes of child mortality
in 2008: a systematic analysis. Lancet 2010;375:1969–87.
Rohde J, Cousens S, Chopra M, Tangcharoensdthien V, Black R,
Bhutta ZA, et al. 30 years after Alma-Ata: has primary health
care worked in countries? Lancet 2008;372:950–61.
Lawn JE, Ketende KW, Cousens SN. Estimating the causes of 4
million neonatal deaths in the year 2000. Int J Epidemiol
;35:706–18.
United Nations International Children’s Emergency Fund.
Definitions basic indicators. [online]. 2010 March [cited on 2010
June 4]. Available at: http://www.unicef.org/
infobycountry/stats_popup1.html
World Health Organization. Neonatal and perinatal mortality:
country, regional and global estimates. Geneva: WHO;2006.
Jehan I, Harris H, Salat S, Zeb A, Mobeen N, Pasha O, et al.
Neonatal mortality, risk factors and causes: a prospective
population-based cohort study in urban Pakistan. Bull World
Health Organ 2009;87:130–8.
Siddiqi A, Khan DA, Khan FA, Razzaq A. Therapeutic drug
monitoring of Amikacin in preterm and term infants. Singapore
Med J 2009;50:486–9.
Thaver D, Ali SA, Zaidi AKM. Antimicrobial resistance among
neonatal pathogens in developing countries. Pediatr Infect Dis J
;28:S19–S21.
Mirzrah EM. Neonatal seizures and neonatal epileptic syndrome.
Neural Clin 2001;19:427–63.
J Ayub Med Coll Abbottabad 2010;22(4)
http://www.ayubmed.edu.pk/JAMC/PAST/22-4/Zardar.pdf
Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL,
Lipp R. New Ballard Score expanded to include extremely
premature infants. J Pediatr 1991;119:417–23.
Thaver D, Zaidi AKM. Burden of neonatal infections in
developing countries. A review of evidence from communitybased studies. Pediatr Infect Dis J 2009;28:S3–S9.
Awoniyi DO, Udo SJ, Oguntibeju OO. An epidemiological
survey of neonatal sepsis in a hospital in Western Nigeria. Afr J
Microbiol Res 2009;3:385–9.
Shaw CK, Shaw P, Thapalial A. Neonatal sepsis bacterial isolates
antibiotics susceptibility patterns at a NICU in a tertiary care
hospital in Western Nepal: a retrospective analysis. Kathmandu
Uni Med J 2007;18:153–6.
Waseem R, Khan M, Izhar TS. Neonatal sepsis. Professional
Med J 2005;12:451–6.
Karlowicz MG, Buescher ES, Surka AE. Fulminant late onset
sepsis in a neonatal intensive care unit, 1988-1997 and impact of
avoiding empirical vancomycin therapy. J Pediatr
;106:1387–90.
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