Emerging antimicrobial resistance in early and late-onset neonatal sepsis
OBJECTIVE To find clinical features and bacteriological agents of neonatal sepsis and to determine their antibiotic sensitivity pattern. DESIGN An observational study. PLACE AND DURATION OF STUDY Paediatric Medicine Unit II, Nishtar Hospital, Multan, from July 2003 to January 2004. PATIENTS AND METHODS Neonates admitted with, or clinically suspected to develop neonatal sepsis during their hospital stay, for another reason, were included in this study. Common clinical features were noted and blood culture reports were analyzed for etiological microorganisms and their antibiotic sensitivity pattern. RESULTS Among the total 115 cases of clinically suspected neonatal sepsis, 62 (54%) had culture proven sepsis. Out of these 26(42%) presented as early onset sepsis and 36(58%) as late-onset sepsis. Among the bacteriological isolates, gram negative organisms (58%) were slightly more common in both early-onset and late-onset sepsis. Among the Gram-negative isolates E.coli (37%) was the commonest organism followed by Klebsiella (9.6%). Among the gram +ve organisms Staphylococcus aureus (32%) was most frequent. All the microorganisms were resistant to ampicillin. E.coli were mostly sensitive to ceftriaxone(75%), ceftazidime (78%), meropenem (88%), imipenem (80%), and ciprofloxacin (52%). Staphylococcus aureus were more sensitive to ciprofloxacin (85%), meropenem (87%), imipenem (82%) as compared to cephalosporins and aminoglycosides. CONCLUSION E.coli and Staph. aureus are the most common organisms causing neonatal sepsis and there is high degree of resistance to commonly used first line antibiotics.