Antimicrobial resistance in blood culture proven sepsis in outborn and inborn neonates.

BACKGROUND

Neonatal sepsis is a major cause of mortality and morbidity, representing a critical emergency that demands swift diagnosis and intervention. Recent trend shows increasing resistance to commonly used antibiotics.

AIMS AND

OBJECTIVES

To study the antimicrobial resistance pattern in blood culture positive neonatal sepsis in outborn and inborn neonates and to compare the clinical profile in neonates with proven sepsis.

METHODS

Bacterial cultures of the blood samples received from neonates with suspected sepsis was performed and antimicrobial susceptibility testing of blood culture positive neonates was done. Antibiotic sensitivity tests were done as per Clinical and Laboratory Standards Institute (CLSI) 2023 guidelines.

RESULTS

Of the 100 participants, 34 were early onset neonatal sepsis and 66 were late onset neonatal sepsis. 35 % of the delivery were vaginal whereas 65 % of the deliveries were by Caesarean section. 17 % of the total neonates delivered had to undergo neonatal resuscitation and 36 % of the neonates had birth asphyxia. The most commonly isolated organisms were Coagulase-negative Staphylococcus species (CoNS) (30 %) followed by Klebsiella pneumoniae (21 %) and Acinetobacter baumannii complex (20 %). 45.1 % were Extended Spectrum beta lactamase (ESBL) producers and 58 % were AmpC beta lactamases producers. Case fatality rate was highest with Klebsiella pneumoniae i.e. 34.6 % followed by Acinetobacter baumannii complex i.e. 23.07 %.

CONCLUSION

Increase in antibiotic resistance organisms can lead to an increase in the neonatal case fatality rate (CFR), so regular surveillance is needed. Comparison between the resistance profile between inborn and outborn neonates provides an insight into the difference in the variety of organisms isolated and also the difference in resistance shown by community acquired and hospital acquired organisms.