Clinico-Bacteriological Study of Neonatal Septicaemia with Special Reference to Antibiotic Resistance Pattern in Sick Newborns Admitted In a Tertiary Care Hospital, Kolkata

Neonatal sepsis is a major healthcare burden responsible for high rates of neonatal mortality. Due to its non-specific signs and symptoms and delay in identification, it poses a great challenge to the clinician in ruling out sepsis at an early stage. The present study was undertaken to identify the recent trends in bacteriological profile associated with neonatal sepsis, their antibiotic resistance pattern and the major risk factors associated with neonatal sepsis. In this cross-sectional study, blood cultures were performed from suspected cases of neonatal sepsis. Growth was identified by standard microbiological techniques and antibiotic susceptibility testing was carried out by Kirby-Bauer disk diffusion method. MRSA (Methicillin Resistant Staphylococcus aureus) and ESBL (Extended Spectrum β-Lactamase) or AmpC β-Lactamase and carbapenemase production was detected phenotypically following CLSI (Clinical and Laboratory Standard Institute) guidelines. Out of 812 blood samples collected, 177 (21.79%) were culture positive, 85 (48.02%) isolates were Gram positive Cocci, 76 (42.93%) were Gram negative Bacilli and 16 (9.03%) were Candida spp. Staphylococcus aureus was the most common pathogen isolated followed by Klebsiella spp. & Acinetobacter spp. A high percentage of MRSA & AmpC producers were observed in present study, these were associated with clinical conditions such as respiratory distress syndrome, prolonged rupture of membrane (>12hrs) & low birth weight. Strengthening rapid detection, along with stringent infection control program and antibiotic stewardship can help to reduce neonatal sepsis and it will allow us to minimise the use of reserve drugs to battle out sepsis at an early stage.