Bacteriological Profile of Neonatal Septicaemia

Abstract

Neonatal septicaemia is a life threatening emergency and is one of the commonest causes of early neonatal mortality and morbidity. This study was conducted in Paropakar Maternity and Women’s Hospital, Kathmandu from 15 th June to 15 th December 2009, to determine the profile of bacteria responsible for neonatal septicaemia, their relation between gestation age, sex, mode of delivery, CRP level, weight, and sign and symptoms of neonates. The susceptibility to common antibiotics was also determined. The study included 690 NICU admitted neonates. Of which, 194 blood samples showed culture positive results indicating total prevalence of 28.1% (194/690). Of which 67.0% organism from Gram negative bacteria and 33.0% organisms from Gram positive bacteria were isolated. In Gram negative, the most predominant was E. coli (51.0% 99/194) followed by Klebsiella pneumoniae (12.4% 24/194), Enterobacter cloacae(0.5% 6/194) and Pseudomonas aerugenosa(0.5% 1/194)from Gram positive most prevalent was Coagulase Negative Staphylococcus (26.3% 51/194)followed by Stap hylococcusaureus(4.6% 9/194) andStreptococcusspp. (2.1% 4/194). The incidence of septicaemia was found to be high in preterm infants 34.8% (p = 0.024). Neonates with low birth weight had higher culture positive result (p = 0.022). Fever, Poor cry,low birth weight, and chorioalantosis are major clinical sign and symptoms associated with bacterial sepsis (p = 0.004). But the study did not found any significant association between sex of the neonates, CRP level, and mode of delivery with growth of the organisms in culture. Themost efficient antibiotic inE. coli was found chloramphenicol (94.9%). InK. pneumoniae againchloramphenicol (87.5%) was found most susceptible, in coagulase negative staphylococcus and Streptococcus spp. maximal efficient antibiotic was found amikacin (90.2%) and to bramycin(77.7%) respectively. K. pnuemoniae,E. coli,E. cloacae, andP. aeroginosa showed a low sensitivity to ampicillin, tobramycin, and gentamycin. Neonatal septicaemia in this hospital mainly caused by gram negative organisms which are resistance to commonly used drugs. Surveillance is required on regular basis. Keywords:Neonatal septicaemia, Bacterial isolates, sensitivity patterns