Bacteriological profile of neonatal septicaemia in a rural hospital

Background: In spite of great advances in antibiotic therapy, neonatal life support measures and early detection of risk factors, neonatal septicaemia continues to be a major cause of morbidity and mortality worldwide. Neonatal septicaemia is responsible for 30–50% of total neonatal deaths in the developing countries like India. Rapid diagnosis and treatment of neonatal septicaemia as early as possible is necessary to prevent the morbidity and mortality caused by it.

Methods: We conducted a study to detect the antimicrobial susceptibility pattern in the isolated organisms. A total of 222 suspected cases of neonatal septicaemia were screened by blood culture. Antimicrobial susceptibility testing is performed by modified Kirby-Bauer disc diffusion method as per the Clinical and Laboratory Standard Institute (CLSI) guidelines.

Results: Out of 222 clinically diagnosed neonatal septicaemia cases, 126 (56.75%) were culture positive, 154 (69.37%) were early-onset septicaemia cases, 153 (68.91%) were low birth weight cases, 131 (59%) were preterm and 139 (62.61%) were males. Klebsiella pneumoniae (38 cases (38.38%) and 20 cases (41.66%)) was the predominant pathogen in early-onset and late-onset septicaemia, respectively, followed by Escherichia coli and Staphylococcus aureus. Gram-negative bacilli were susceptible to imipenem (96.15%), followed by ciprofloxacin and amikacin, while Gram-positive cocci were susceptible to vancomycin (89.19%), followed by cefotaxime, teicoplanin, ceftazidime and ceftriaxone.

Conclusion: Every hospital should have their own antibiotic policy by monitoring the antibiotic-sensitivity pattern against the common isolates, and better diagnostic aids should be employed for early detection of neonatal septicaemia to avoid the burden of mortality resulting from neonatal septicaemia.