NEONATAL SEPSIS

Abstract

Objective: To find out the bacterial pathogens in neonatal sepsis and to
determine antimicrobial sensitivity patterns of these pathogens. Place and Duration: At the Neonatal Unit of Ghurki
Trust Teaching Hospital Lahore, from February 2003 to December 2004. Design: It was an analytical comparative
study, done in prospective fashion. Subjects and Methods: A total of 100 culture proven neonates of sepsis were
included. Clinical data including neonatal and maternal history, physical examination and laboratory data including
blood counts and cultures were recorded. The cases that have already been given antibiotics were excluded. Standard
disc-diffusion method was used to assess the sensitivity pattern for the antibiotics (ampicillin, gentamicin, cefotaxime,
ceftazidime, amikacin and imipenem). Results: Out of total of 100 cases, 64 belonged to Early onset Sepsis (EOS)
and 36 belonged to Late onset Sepsis (LOS). Gram negative organisms were isolated from more than 80% of the
cases. E. Coli was the commonest isolate (n=34), followed by Klebsiella (n=30) and Pseudomonas (n=13), involving
both early and late onset groups. No isolate of group B streptococci (GBS) was found. Out of 34 isolates of
E.Coli,14.70%(n=5),17.6%(n=6),41.17%(n=14),61.76%(n=21),79.4%(n=27) and 97.05%(n=33) were sensitive to
ampicillin, gentamicin, cefotaxime, amikacin, ceftazidime and imipenem respectively. Klebsiella and Pseudomonas also
showed a low sensitivity to ampicillin, gentamicin, and cefotaxime, while good sensitivity to amikacin, ceftazidime and
imipenem. The mortality was significantly high (P<0.05) in low birth weight infants. Conclusion: Improvement in
antenatal and natal services is mandatory to reduce incidence of neonatal sepsis and related mortality. Most of the
organisms are resistant to commonly used drugs. Surveillance is required on regular basis.