Open AccessChanging Trends of Antimicrobial Resistance in Neonatal Sepsis: Experience from a Tertiary Care Hospital from West Bengal, India
Author(s) -
Manjula Dutta,
Prasenjit Mitra,
Shankha Subhra Nag,
Abhijit Dutta
Publication year - 2021
Publication title -
journal of clinical and diagnostic research
Language(s) - English
Resource type - Journals
eISSN - 2249-782X
pISSN - 0973-709X
DOI - 10.7860/jcdr/2021/49015.15136
Subject(s) - cefotaxime , medicine , ampicillin , neonatal sepsis , microbiology and biotechnology , acinetobacter baumannii , acinetobacter , ceftazidime , amoxicillin , sepsis , antibiotics , biology , pseudomonas aeruginosa , genetics , bacteria
Introduction: Sepsis is the second leading cause of neonatal mortality in India. Emergence of highly resistant microorganisms as an aetiology of neonatal sepsis is a matter of serious concern. Aim: To study the prevailing aetiological agents in neonatal sepsis and their antimicrobial susceptibility pattern. Materials and Methods: A prospective observational study was performed in a tertiary care teaching hospital in neonatal care units in North Bengal Medical College and Hospital, West Bengal, India, over a period of two years from March 2017 to February 2019. All the neonates having clinical features suggestive of sepsis were subjected to blood culture using BacT/ALERT® PF Plus. Microbial identification and antibiotic susceptibility testing was done by VITEK-2 automated systems. Chi-square test was done using Epi info software version 7.1 and p-value <0.05 was considered significant. Results: Out of 403 neonates investigated for suspected sepsis, 156 (38.7%) were found to be culture positive. Klebsiella pneumoniae was the most common organism isolated (n=90, 57.7%) followed by Staphylococcus aureus (n=24, 15.4%) and Acinetobacter baumannii (n=10, 6.4%). Klebsiella pneumoniae showed a very high degree of resistance to ampicillin, amoxycillin- clavulenic acid (100% each), cefotaxime (93.4%), ceftazidime (92.3%), gentamycin (94.5%) and tobramycin (94.5%). High resistance of Staphylococcus aureus was seen against ampicillin (100%), cloxacillin (62.5%), amoxicillin-clavulenic acid (70.9%), and cefotaxime (79.2%). Few isolates of Klebsiella pneumonia (6.6%), Acinetobacter baumannii (60%) and Enterobacter cloacae (50%) were sensitive only to colistin and tigecycline. Conclusion: Most of the isolates showed very high degree of resistance against first line of antibiotics recommended by World Health Organisation (WHO) (ampicillin and gentamycin or amikacin) for empirical treatment of neonatal sepsis. Emergence of highly resistant organisms sensitive only to colistin and tigecycline should be considered as an eye opener. Strict adherence to sepsis prevention along with regular surveillance of organisms and their sensitivity patterns is the need of the hour to improve survival by contributing to antibiotic stewardship.