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Background: Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life. The reported incidence of neonatal sepsis varied from region to region. Drug resistance has been reported from various parts of the world. Epidemiology of neonatal sepsis has not been methodically studied in the north eastern part of the country. The purpose of this study is to provide a, evidence-based approach to the management of neonates with sepsis. Objective: This study is taken up to find out the incidence of culture confirmed neonatal sepsis, its microbiological profile and antibiotic sensitivity pattern and influence of maternal risk factors on them. Method: In a retrospective record review pattern all intramural culture confirmed neonatal sepsis cases were included and the maternal risk factors, organisms isolated and the antibiogram was recorded and analyzed. Results: The incidence of culture confirmed sepsis cases was 4.1 per 1000 live birth with preponderance to male sex(58%) and tribal ethnicity(60%). Fifty eight percent(58%) of the cases had some or other form of maternal risk factor. Premature delivery, instrumentation and PROM >24 hours were the most frequently occurring maternal risk factors. In the cases with maternal risk factors Klebsiella pneumonia(26.3%), Escherichia coli(10.5%) and Pseudomomas sp.(2.6%) are more frequently isolated whereas, in cases without maternal risk factors Staphylococcus aureus(18.42%), Klebsiella pneumonia (15.78%) and coagulase negative Staphylococcus(7.9%) were frequent isolates. Most isolates had resistance to first line (Ampicillin+ Gentamicin) and second line( Ceftriaxone + amikacin) antibiotics. Klebsiella and E. Coli were mostly sensitive to Chloramphenicol and quinolones , whereas Staphylococcus aureus and coagulase negative Staphylococcus were susceptible to Vancomycin. Conclusion: Culture confirmed neonatal sepsis occurred among the intramural neonates at a rate of 4.1 per 1000 live birth with male and tribal preponderance. Maternal risk factors were present upto 58% of the cases. Klebsiella pneumonia, Staphylococcus aureus, Escherichia coli and coagulase negative Staphylococcus were the leading bacterial isolates. Chloramphenicol , quinolones and Vancomycin were effective against most of the isolates . Keywards: Neonatal sepsis, intramural cases, maternal risk factors ,blood culture, bacteriological isolates/agents, antibiogram, Incidence, evidence-based approach. Abbreviations:National Neonatal Perinatal Database (NNPD), maternal / perinatal risk factors(MRF),Neonatal intensive care unit( NICU), Muller Hington Agar(MHA), premature rupture of membrane(PROM).

iosr journal of dental and medical sciences

Incidence, Maternal Risk Factors, Microbiological Profile And Antibiotic Sensitivity Pattern in Neonatal Sepsis A Hospital Based Study At Agartala, Tripura.