Objectives: This study was undertaken to investigate the distribution of etiological agents and antimicrobial resistance pattern among the blood culture-positive cases of neonatal sepsis admitted to a level III neonatal care unit in a teaching hospital Kolkata, Eastern India for the period of 4 years
(2014 – 2017).
Methods: Blood culture was done for all babies admitted with clinical sepsis or with positive sepsis screen by automated BACTEC 9050 system. In positive cases, identification of organism was done followed by antimicrobial sensitivity testing by Kirby Bauer disc diffusion method using Clinical Laboratory Standard Institute Guidelines. Multi-drug resistance (MDR) was defined as presence of resistance to at least three of the five antibiotic groups in case of gram negative bacteria. Chi-squared test was performed to test association between different groups.
Results: Out of 4781 cases of clinical neonatal sepsis, 415 (8.68%) were culture positive. In 240 (69%) cases, the pathogens belonged to the family Enterobacteriaceae. Gram-positive cocci account for 38 (11%) cases of positive blood culture cases. Klebsiella is the foremost infectious agent with positive in 187(54%) of all bacterial isolates . Enterobacteriaceae positive babies had 90 (36.9%) death which is significantly higher than that associated with others. Klebsiella tops the list of MDR organisms with highest mortality.
Conclusions: Gram-negative pathogens and more specifically Klebsiella account for a substantial disease burden of neonatal sepsis in form of antibiotic resistance , multidrug resistance and mortality in a neonatal intensive care unit .
