Bacteriological profile and antibiotic sensitivity pattern of neonatal Septicaemia using automated blood culture and vitek-2 systems in a tertiary care hospital, Bengaluru

Background: Neonatal sepsis refers to systemic infection of the newborn. It is characterized by nonspecific symptoms, and documented by positive blood culture. An estimated 1.6 million deaths occur due to neonatal infections worldwide, 40% of them being limited to developing countries. The incidence of neonatal sepsis in our country is around 30 per 1000 live births. These children are more likely to have neuro developmental side effects. Therefore it is important to diagnose and treat the condition as early as possible. Objective: The aim of the present study is to determine the microbiological profile of neonates with sepsis and to determine their antibiotic susceptibility pattern using automated systems-BacT/ALERT and Vitek 2 systems. Materials and Methods: This study is a Retrospective study conducted between December 2017 and February 2018 at NICU, Vani Vilas hospital, BMC&RI, Bengaluru. All admitted neonates with clinical signs and symptoms of sepsis at the time of admission or who developed sepsis during their hospital stay were included in the study. Blood samples were collected aseptically from neonates suspected with neonatal sepsis. Samples were inoculated into pediatric automated blood culture bottle “pediatric” (yellow, 30 ml, BacT/ALERT PF). Cultures with positive results were streaked on blood and Mac Conkey agar. Identification and antibiotic sensitivity were done using Vitek-2 systems. Results: In this study blood samples were collected from 253 neonates admitted to NICU ofVanivilas hospital, 72 samples were found to be culture positive. The most common organism isolated from both Early onset sepsis(EOS) and Late onset sepsis(LOS) was Klebsiellapneumoniae57% and 53% respectively. Most of the Klebsiella organisms were sensitive to Piperacillin-tazobactum, Amikacin and Imepenem. The next most common organism isolated was Staphylococcus aureus in EOS and Enterococcus species in LOS. The most important risk factors found were preterm and low birth weight, with respiratory distress being the most frequent presentation. Conclusion: Appropriate identification of sepsis source, prompt antibiotic prescription and aggressive management can effectively prevent adverse events following neonatal sepsis. There is requirement of simple and sustainable intervention to reduce the burden of multidrug resistant pathogens causing sepsis. The implementation of hand washing, barrier nursing and antibiotic stewardship policies is need of time.