Blood culture isolates in neonatal sepsis and their sensitivity in Anand District of India.

OBJECTIVES

To study prevalent organisms in neonatal sepsis, their sensitivity to antibiotics and outcome in neonates with culture proven sepsis.

METHODS

This was a retrospective study of hospital records of 4 y. From 276 culture positive reports of 226 newborns, organisms, their sensitivity to different antibiotics were studied and their outcome was compared to 571 culture negative newborns. Growth detection was done by BacT/ALERT®PF system.

RESULTS

Most common isolates were Klebsiella (42.4 %), Coagulase-negative staphylococci (11.2 %), Enterobacter (9.4 %), Escherichia coli (9.1 %), Pseudomonas (5.4 %) and Acinetobacter (4.7 %). Gram negative organisms were predominant both in early-onset and late-onset neonatal sepsis as well as in inborn and outborn newborns and most of them were resistant to commonly used first line antibiotics like ampicillin, gentamicin and cephalosporins. Extended Spectrum Beta Lactamase producing Klebsiella and Escherichia coli were 94.87 % and 92 %, respectively. Methicillin resistant Staphylococci were 33 %. Vancomycin resistance among the Enterococci was 20 %. Most effective first line antibiotic combinations were amikacin with levofloxacin and amikacin with piperacillin-tazobactam. Survival in culture positive newborns (43.36 %, 95 % CI 37.07 to 49.88) was poor than culture negative newborns (53.06 %, 95 % CI 48.96 to 57.12).

CONCLUSIONS

Gram negative organisms were most common cause of neonatal sepsis and were resistant to first line antibiotics. Blood culture positive newborns had poor outcome than culture negative newborns.