Objective: To determine the Bacteriological Profile and Sensitivity Pattern in Neonatal Sepsis in the Nursery of a Tertiary Care Centre in Bareilly.

Method: A prospective observational study was conducted in the Department of Pediatrics, Rohilkhand Medical College and Hospital, Bareilly, over a period of one year (November2018– October 2019) on 140 patients, after getting clearance from the ethical Committee. All babies were admitted in NICU with risk factors or clinical features of neonatal sepsis or those evaluated for sepsis during their admission period, were included in the study, after taking written consent from their parents. A detailed history and thorough examination were done of all babies enrolled and their sepsis screen was sent.

Results: The sepsis screen analysis of all the enrolled patients showed that, out of all sepsis positive cases, 30% cases had a gram-positive infection while 70% cases had a gram-negative infection. 40% cases of all Gram-positive sepsis patients had Staphylococcus aureus infection, while 42% cases of Gram-negative sepsis patients had Klebsiella pneumoniae infection.

It was observed that >50% Gram positive organisms were sensitive to Meropenem, Piperacillin + Tazobactam, Amikacin and Vancomycin. While >50% Gram negative organisms were sensitive to Meropenem and Piperacillin + Tazobactam.

Conclusion: Thus, it can be concluded from the data that an empirical antibiotic therapy of Piperacillin + Tazobactam and Amikacin would be most efficacious in our set up as first line antibiotics rather than the combination of Cefotaxime and Amikacin which were being used up till now.

1. UNICEF, WHO, The World Bank, and The United Nations, Levels and Trends in Child Mortality, UNICEF, New York, NY, USA,2011.
2. Wu Jh, Chen CY, Tsao PN, Hsieh WS and Chou HC. “Neonatal sepsis: a 6-year analysis in a neonatal care unit in Taiwan,” Pediatrics and Neonatology, 2009; 50(3): 88-95.
3. National Neonatology Forum NNPD Network. National Neonatal-Perinatal Database: Report for 2002-2003. New Delhi: National Neonatology Forum NNPD Network;2005.
4. Thaver D, Zaidi AK. Burden of neonatal infections in developing countries: A review of evidence from community-based studies. Pediatr Infect Dis J2009;28:3-9.
5. Mathur NB. Neonatal sepsis. Indian Pediatr1996;33:663-74.
6. Shah AJ, Mulla SA, Revdiwala SB. Neonatal sepsis: High antibiotic resistance of the bacterial pathogens in a neonatal intensive care unit of a tertiary care hospital. J ClinNeonatol2012;1:72-5.
7. Jonnala RNR, Eluzai Z, Rao NS. Clinical and Laboratory Profile of Neonatal Sepsis. International Journal of Medical and Applied Sciences,2013;2(4):319-31.
8. Sharma PP, Halder D, Dutta AK, Dutta R, Bhatnagar S, Bali A, et al. Bacteriological profile of neonatal septicemia. Indian Pediatr,1987;24:1011–7.
9. Jain NK, Jain VM, Maheshwari S. Clinical profile neonatal sepsis. Kathmandu University Medical Journal,2003;1:117-120.
10. Khinchi1 Y R, Anit K, Satish Y. Profile of Neonatal sepsis. Journal of College of Medical Sciences-Nepal,2010;6(2):1-6.
11. Amru R. Clinical and bacteriological profile of Neonatal sepsis.MD Thesis. Osmania Medical College, Hyderabad; 1997.
12. Agnihotri N, Kaistha N, Gupta V. Antimicrobial susceptibility of isolates from neonatal septicemia. Jpn J Infect Dis, 2004; 57:273–5.
13. A S M Nawshad Uddin, chowdhury M A K Azad, Hoque Mahbul and Gray L. Clinical and Bacteriological Profile of Neonatal Septicemia in a Tertiary level Pediatric Hospital in Bangladesh. Indian Pediatr,2002;39:1034-1039.
14. Manucha V, Rusia U, Sikka M, Faridi MM, Madan N. Utility of hematological parameter and C-reactive protein in the detection of neonatal sepsis. J Paediatr Child Health,2002;38:459-464.
15. Simiyu DE. Neonatal septicaemia in low birth weight infants at Kenyatta National Hospital, Nairobi. East Afr Med J,2005; 82:148-52.
16. Anwer SK, Mustafa S, Pariyani S, Ashraf S, Taufiq KM. Neonatal sepsis: an etiologic study. J Pak Med Assoc, 2000;50:91-94.
17. Milledge J, Calis JC, Graham SM, Phiri A, Wilson LK, Soko D, Mbvwinji M, Walsh AL, Rogerson SR, Molyneux ME, Molyneux EM. Aetiology of neonatal sepsis in Blantyre, Malawi: 1996-2001. Ann Trop Paediatr,2005;25:101-10.
18. Kapoor L, Randhawa VS, Deb M. Microbiological profile of neonatal septicemia in a pediatric care hospital in Delhi.JCommun Dis,2005;37:227-32.
19. Movahedian AH, Moniri R, Mosayebi Z. Bacterial Culture of Neonatal Sepsis. Iranian J Publ Health,2006;35:84-89.
20. National Neonatology Forum NNPD Network. National Neonatal-Perinatal Database: Report for 2002-2003. New Delhi: National Neonatology Forum NNPD Network;2005.
21. Zakariya BP. Neonatal sepsis in a tertiary care hospital in South India: Bacteriological profile and antibiotic sensitivity pattern. Indian J Pediatr, 2011;78(4):413-7.
22. Afroza S. Neonatal sepsis-- a global problem: an overview. Mymensingh Med J, 2006;15:108-14.
23. Levine EM, Ghai V, Barton JJ, Strom CM. Intrapartum antibiotics prophylaxis increases of gram negative neonatal sepsis. Infec Dis Obstet Gynaeco,1999;l7:210-213.
24. Waheed M, Laeeq A, Maqbool S. The etiology of neonatal sepsis and patterns of antibiotic resistance. J Coll Physicians Surg Pak,2003;13:449-52.
25. Mokuolu AO, Jiya N, Adsiyun OO. Neonatal septicemia in Ilorin: bacterial pathogens and antibiotic sensitivity pattern. Afr J Med Sci, 2002;31:127-30.
26. Ellabib MS, Ordonez A, Ramali A, Walli A, Benayad T, Shebrlo H. Changing pattern of neonatal bacteremia. Microbiology and antibiotic resistance. Saudi Med J,2004;25:1951-6.
27. Shrestha B, Pokhrel BM, Mohapatra TM. Antibiotic susceptibility pattern of nosocomial isolates of staphylococcus aureus in a tertiary care hospital, Nepal. Nepal Med Assoc J,2009;48:234-8.

Niraj Kumar

Junior Resident, Department of Pediatrics, Rohilkhand Medical College and Hospital, Bareilly, Utter Pradesh