Background and Aims To study prevalent organisms causing sepsis, their sensitivity pattern and outcome in newborn babies with culture proven sepsis.
Methods Retrospective observation of hospital records of 4 years from November 2007 to October 2011 from 276 culture positive reports with their sensitivity to the antibiotics and measured outcome of the culture proven sepsis.
Results Most common blood culture isolates in decreasing order of frequency were Klebsiella (42.4%), Coagulase Negative Staphylococci (11.2%), Enterobacter (9.4%), Escherichia coli (9.1%), Pseudomonas (5.4%) and Acinetobacter (4.7%). Gram negative organisms were predominant in early and late onset neonatal sepsis as well as in inborn and outborn babies. Staphylococcus aureus and Enterococci were uncommon. Candida species were isolated in early onset sepsis and in babies weighing more than 1500 gm. Most gram negative organisms were resistant to ampicillin, gentamicin and cephalosporins. Sensitivity of amikacin, levofloxacin and piperacillin-tazobactam against Gram negative organisms ranged from 25% to 75%. Incidence of Methicillin Resistant Staphylococcus Aureus and Vancomycin resistant Enterococci was 33% and 20% respectively. Most Candida isolates were sensitive to antifungals. The most effective first line antibiotic combinations were amikacin with levofloxacin and amikacin with piperacillin-tazobactam. Overall survival rate in culture positive neonates was 43.4%.
Conclusion Gram negative organisms were the most common cause of neonatal blood stream infection with high degree of resistance to commonly used first line antibiotics. These findings would help judicious selection of antibiotics when initiating them before the culture reports are available.