Publication: Trend of bacteriological profile and antibiotics sensitivity pattern in neonates with late onset sepsis
Date
2025
Journal Title
Journal ISSN
Volume Title
Publisher
Madhesh Institute of Health Sciences (MIHS)
Abstract
ABSTRACT:
Background: Neonatal sepsis is a major cause of morbidity and mortality in low- and middle-income countries (LMICs). It is categorized as early onset sepsis (EOS, ≤72 hours) and late onset sepsis (LOS, >72 hours). The World Health Organization (WHO) has emphasized antibiotic stewardship. In LMICs, antibiograms are crucial where sepsis significantly contributes to neonatal deaths. Objective: To analyze trends in bacteriological profile and antibiotics sensitivity in neonates with Late Onset Sep- sis (LOS). Methods: This was a 10-year retrospective study of culture-proven LOS cases. Demographics, isolate types, and sensitivity patterns were recorded. Multidrug-resistant (MDR) gram-negative isolates were defined as resistance to ≥3 of 5 antibiotic classes: extended-spectrum cephalosporins, carbapenems, aminoglycosides, fluoroquinolones, and piperacillin-tazobactam. Results: Among 14,336 NICU admissions (2010–2019), 6092 (42.5%) were evaluated for sepsis, and 647 (10.6%) had culture-positive LOS. Gram-negative organisms comprised 488 (75.3%) isolates—Klebsiella (35.3%), E. coli (13.3%), and Acinetobacter (10.5%) were most common. Gram-positive isolates (24.7%) included S. aureus (9.4%), coagulase- negative staphylococci (10.5%), and Enterococcus (4.8%). High MDR rates were observed in Klebsiella (56.3%), E. coli (56.9%), and Acinetobacter (86.8%). Methicillin resistance was seen in 77.3% of S. aureus and 74.2% of Enterococcus.
Conclusions: Alarming antimicrobial resistance in both gram-negative and gram-positive organisms calls for urgent at- tention. Antibiotic stewardship and regular antibiogram surveillance are essential to develop effective hospital policies.
Description
Department of Pediatrics, Madhesh Institute of Health Sciences, Janakpur, Nepal
Consultant Neonatologist, Department of Pediatrics, ESIC Medical College, Faridabad, Haryana- 121001, India
Assistant Professor, Department of Pharmacology, Bharati Vidyapeeth University Medical College, Pune-Satara Road, Pune, Maharashtra- 411043, India
Assistant Professor, Department of Pediatrics, AIIMS, Nagpur, Maharashtra-441108, India
Professor and Head, Department of Neonatology, Bharati Vidyapeeth University Medical College, Pune-Satara Road, Pune, Maharashtra- 411043, India