Open AccessAntimicrobial resistance in neonates with suspected sepsis
Author(s) -
Sunil Kumar Yadav,
Sumit Agrawal,
Sudhir Singh,
Arun Giri,
Gurbax Singh,
Rakesh Ghimire,
Alex G. Stewart,
K L Show,
Francis Moses
Publication year - 2021
Publication title -
public health action
Language(s) - English
Resource type - Journals
ISSN - 2220-8372
DOI - 10.5588/pha.21.0038
Subject(s) - medicine , sepsis , neonatal sepsis , imipenem , antibiotic resistance , antibiotics , neonatal intensive care unit , linezolid , pediatrics , staphylococcus aureus , vancomycin , microbiology and biotechnology , bacteria , biology , genetics
SETTING: Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. OBJECTIVE: To determine the pattern of antimicrobial resistance and hospital exit outcomes in neonates with suspected sepsis in a tertiary neonatal intensive care unit (NICU). DESIGN: This hospital-based cohort study was conducted to follow patients from January to December 2019. All identified cases of suspected sepsis were enlisted from hospital records. RESULTS: Sepsis was suspected in 177 (88%) of the 200 cases admitted in the NICU; 52 (29%) were culture-positive. Pseudomonas was the predominant organism isolated ( n = 40; 78%), followed by coagulase negative staphylococcus ( n = 12, 23%). Nine (17%) of the 52 isolates were resistant to the Access and Watch group of antibiotics, including some resistance to Reserve group drugs such as imipenem and linezolid. Most treated cases ( n = 170, 96%) improved, although 7 (4%) left against medical advice. CONCLUSION: Most of the pathogens were resistant to WHO Access and Watch antibiotics and occasional resistance was observed to Reserve group drugs. Most sepsis was caused by Gram-negative bacilli. Improving turnaround times for antibiotic sensitivity testing using point-of-care testing, and a greater yield of culture-positive results are needed to enhance the management of neonatal sepsis.