NEONATAL SEPSIS;

COMMON BACTERIAL ISOLATES AND THEIR ANTIMICROBIAL SUSCEPTIBILITY PATTERNS IN NEONATAL INTENSIVE CARE UNIT, ISLAMABAD

Abstract

Introduction: Neonatal sepsis is a systemic condition characterized by
bacteremia that occurs in the first month of life. It is a fatal condition and need to be treated
promptly. Bacterial isolates include both gram positive and negative bacteria and the cure
of condition is highly dependent on antimicrobial drug sensitivity and resistant patterns. It is
there for utmost important to known commonly occurring bacteria in neonatal septic states
and their drug sensitivity patterns. Objectives: To determine the frequency of the bacterial
isolates in blood and their sensitivity patterns to commonly used antibiotics in neonatal sepsis.
Setting: Neonatal intensive care unit(NICU), Department of Shifa International Hospital. (SIH),
Islamabad. Study Design: Cross sectional. Duration: This study was conducted between 6 1st
June 2013 to 30th November 2013. Subject and Methods: A total of 180 neonates, admitted
in NICU with evidence of clinical sepsis i.e. with signs and symptoms suggestive of septicemia
(fever, lethargy, reluctance to feed, seizures, and irritability) were included in this study. The
samples for blood cultures were taken. Identification of bacterial isolates was carried out by the
standard bacteriological techniques, which include gram staining and bacterial cultures and
antimicrobial sensitivity patterns which was performed by modified Kirby and Bauer disc diffuse
method as per CLSI (Clinical and Laboratory StandardsInstitute)guidelines.A predesigned
Performa was filled. Results: Culture revealed bacterial growth in 7.2% samples. Gram negative
organisms were observed in 6.67% and only 1 were gram positive. In this study, 50% and 100%
of E-coli were sensitive to ampicillin, meropenem and amikacin, gentamycin respectively. Sixty
to 100% of pseudomonas was sensitive to ceftazidime, tazobactum, meropenem and 100%
of enterococcus was sensitive to ampicillin and vancomycin. Conclusion: Antimicrobial drug
resistance and constantly changing resistance patterns is emerging issues in various groups
of infections and septic states, especially for routinely used antibiotics as found in our study.
Thus by prescribing rational use of antimicrobial as per bactriogram, It‘ll be easier totreat sepsis
effectively and economically and reduce the mortality and morbidity related to neonatal sepsis.