Bacterial Resistance in Neonates With Sepsis, Not Responding to First Line Antibiotics

Abstract

Objective: To determine the bacterial resistance in neonates with sepsis not responding to first line antibiotics, at Neonatal Intensive Care Unit, Nazeer Hussain Medical Complex Hyderabad

Study Design: Descriptive / cross sectional study.

Place and duration of study: This study was conducted at the Neonatal Intensive Care, Nazeer Hussain Medical Complex Hyderabad from July to December 2016

Materials and Methods: A total of 63 neonates admitted to NICU, Nazeer Hussain Medical Complex Hyderabad with suspected neonatal sepsis and fulfilling the inclusion criteria were included.

After taking blood culture second line broad spectrum antibiotics (Meropenem, Vancomycin) started and blood culture followed for the presence of bacteria and its sensitivity to various antibiotics, antibiotics resistance to first line antibiotics (Amikin, Cefotaxime, Ampicillin) was also followed.

Results: Most common age of presentation was <5 days ie 76.2%, having the male predominance 85.7% and most neonates were between 2 to 3 Kg ie 85.7%. Most neonates were born at term 61.9%. Most common organism was Staphylococcus Aureus 24 (38%). Death occurred in 9 (14.3%) neonates. Blood Culture was negative in 24 (38.09%) neonates. Klebsiella Pneumonia was the most common organism isolated and it was sensitive to Colistin and Meropenem in 100% cases, while it was resistant to Amikacin and Ampicillin in 100% cases.

Conclusion: Proper Blood Culture and Judicious use of antibiotics in neonatal sepsis can reduce the mortality, even in neonates who did not respond to first line antibiotics. Care should be taken, while using second line antibiotics, because resistance to second line antibiotics is emerging, hence there is need of vigilance and Blood Culture follow up to know the bacterial sensitivity and proper antibiotic coverage.