BACTERIOLOGICAL PROFILE OF NEONATAL SEPTICEMIA CASES AND THE ANTIMICROBIAL RESISTANCE PATTERN IN A TERTIARY CARE HOSPITAL OF CENTRAL NEPAL

Abstract

Background : Neonatal septicemia is an important cause of morbidity and mortality. Knowledge of bacteriological profile and antimicrobial susceptibility is very important for management of such infection. Objective: To determine the bacteriological profile of neonatal septicemia and the antimicrobial resistance pattern. Materials and Methods: A total of 377 neonatal blood cultures samples were processed in the Department of Microbiology, Chitwan Medical College Teaching Hospital, Nepal in one year period. Isolation, identification and antimicrobial susceptibility was determined by standard microbiological methods. Results: Of 377 specimens studied, bacterial growth was obtained in 80 specimens (2.1%). Gram-positive organisms were isolated in 35 (43.7%) and Gram-negative in 45 (56.3%) specimens. Staphylococcus aureus was the most common organism (23/70 isolates) isolated in early-onset septicemica followed by Acinetobacte r species (18/70 isolates) and Klebsiella species. However, late-onset septicemia was primarily associated with Acinetobacte r species (4/10 isolates). On performing antimicrobial susceptibility testing, Gram-positive organisms exhibited maximum resistance to Cotrimoxazole (100%) followed by Penicillin (75%) and Cephalexin (50%) while Gram-negative organism to Norfloxacin (100%) followed by Cefixime (90.6%), Cotrimoxazole (80%) and Ceftriaxone (78.5%) among all antibiotics tested. Conclusion : A wide spectrum of antimicrobial resistant bacterial agents are responsible for neonatal septicemia in our set up. A longitudinal surveillance program coupled with good infection control practices and rational use of antibiotics is important to reduce infection rate and ensure better therapeutic success.