Pathogens and Antibiogram of Blood Stream Isolates in Neonatal Sepsis: Findings from a Tertiary Care Hospital, Bangladesh

Background: Neonatal sepsis is associated with increased mortality and morbidity including neurodevelopmental impairment and prolonged hospital stay. The organism responsible for neonatal sepsis may vary across geographical boundaries even from institution to institution and with the time of illness thus periodic surveillance is a necessity. The present study was therefore carried out to determine the common pathogens and their antibiotic sensitivity pattern. Objectives: To isolate the bacterial agents causing neonatal sepsis determine the sensitivity pattern of the causative bacterial agents. Methods: This cross-sectional study was carried out in the neonatal intensive care unit of BSMMU from December 2012 to July 2013. Neonates (0-28 days) who were admitted in neonatal intensive care unit with suspected sepsis were included in this study. After admission written informed consent from parents were obtained and emergency management was given to the baby and then septic screening along with blood culture and antimicrobial sensitivity were done. All data were compiled, tabulated and then analyzed by SPSS V.12 according to the objectives of the study. Results: A total 94 newborn babies with suspected sepsis were included in this study. Most of the babies (54.3%) were admitted within 24 hours after birth, 86.17% babies were preterm and 81.92% babies birth weight was <2500 gm. There was preponderance of male babies over females comprising 53% male and 47% female. Among the suspected septic newborns 27.66% of babies had culture-positive sepsis and 73.41% of babies had culture-negative sepsis. Among the culture-positive cases, 72% of babies were developed late-onset sepsis and 28% of babies were developed early onset sepsis. The isolates from blood culture were Klebsiella pneumoniae in 9 (34%) cases, 6 (23%) cases were E. coli, Acinetobacter, Staphylococcus was found in 2 (8%) cases and Pseudomonas, Enterobacter, and Citrobacter were found in 1 (4%) case. Gram negative organisms predominated on Gram positive bacteria. Imipenem, Ciprofloxacin, Colistin, and Netilmicin were the most sensitive antibiotics to the commonly isolated organisms. Almost all organisms were resistant to Ampicillin and Gentamicin. Conclusion: Klebsiella pneumoniae is the commonest organism responsible for neonatal sepsis in BSMMU. There is an overall decline in antibiotic susceptibility to commonly isolated bacterial pathogens.