Journal of Mahatma Gandhi Institute of Medical Sciences (Jan 2018)

Late-onset neonatal sepsis: Overview of risk factors and bacterial etiology in a tertiary care hospital in North India

  • Sunit Pathak,
  • Dipti Agarwal,
  • Pratibha Singh,
  • Meenakshi Pathak,
  • Shamrendra Narayan

DOI
https://doi.org/10.4103/jmgims.jmgims_33_16
Journal volume & issue
Vol. 23, no. 2
pp. 69 – 72

Abstract

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Background: Septicemia in neonates is one of the leading causes of mortality. The increasing number of multidrug-resistant pathogens is a serious concern. With this background, this study was done to evaluate the risk factors of late-onset sepsis (LOS) (community- and hospital-acquired infections) in newborns and to determine the antibiotic resistance pattern of the isolates in these infections. Materials and Methods: This retrospective study was conducted at Sarojini Naidu Medical College, Agra, on newborns admitted between August 2015 and January 2016. Newborns with the final diagnosis of sepsis obtained from the case records during the study period were included in the study. Those newborns with positive blood culture results were included in the study. Clinical details and antibiotic sensitivity of the isolates were also obtained from the records. Results: Sixty-eight newborns with LOS (38 community- and 30 hospital-acquired infections) were included in the study. Staphylococcus and Klebsiella were the most common bacteriological isolates for both community- and hospital-acquired infection cases in 36%, 26% and 26%, 33.3%, respectively. Home delivery (52.6%) and faulty breastfeeding were (57.8%) seen in significantly larger numbers in community-acquired infections (P = 0.03 and 0.01, respectively) whereas invasive procedures such as intubation were seen in 40% of nosocomial infections as compared to only 5.2% of community-acquired infections. Antibiotic susceptibility pattern in both the infections was similar. Staphylococcus aureus was susceptible to vancomycin in 100% cases while high resistance was seen for ampicillin in both the groups. Similarly, gentamicin was found to be resistant in both the groups for Klebsiella while imipenem was susceptible in 100% cases. Conclusion: Both community- and hospital-acquired infections had similar isolates and antibiotic susceptibility pattern; however, the risk factors associated with both the infections differed.

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