Bacteriological Profile and Antibiotic Susceptibility Pattern of the Isolates among the Neonatal Septicemia in Northeast India
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2019, Vol 6, Issue 11
Abstract
Background: Bacterial resistance to antibiotics was a global problem. Multidrug-resistant bacteria causing neonatal septicemias were increasing in the world. It was difficult to compare the bacterial profile and antibiotic susceptibility pattern of the isolates among the neonatal septicemia between countries because the epidemiology of neonatal septicemia was extremely variable. Objective: Timely identification of bacterial profile and antibiotic susceptibility pattern of the isolates among the neonatal septicemias are essential to guide the clinicians regarding both the empirical and definitive treatments of neonatal septicemia. Materials and Methods: Based on the AIIMS protocol 2014 of neonatal sepsis-World Health Organization newborn CC, an operational definition of clinically diagnosed neonatal septicemia was established for the selection of participants in the study for blood culture and sensitivity test (CST). Hence, in this study, blood CST was done only among the selected patients for clinically diagnosed neonatal septicemia as recommended in the National Committee for Clinical Laboratory Standards. Results: This study observed that there was a shift from the predominance of Gram-negative organisms to Gram-positive organisms, especially Staphylococcus aureus. Acinetobacter and Citrobacter were emerging organisms.In this study, aminoglycosides and fluoroquinolones were sensitive to organisms, especially in Gram-negative organisms. Imipenem and meropenem were also sensitive in both Gram-positive and Gram-negative organisms. Imipenem was more sensitive to organisms than meropenem. Tobramycin, doxycycline, gatifloxacin, and chloramphenicol were more sensitive to organisms than erythromycin, azithromycin, and clindamycin. Conclusion: Early clinical diagnosis and prompt initiation of empirical antimicrobials therapy to patients of pending culture sensitivity reports for definitive therapy may be life-saving. Hence, periodic surveillance for bacteriological profile and antibiotic susceptibility pattern of the isolates among the neonatal septicemia for appropriate choice of antimicrobials for empirical therapy can be outlined and reevaluated in a timely manner to save the life of 5 million neonatal deaths a year, with 98% occurring in developing countries and limited resource rural areas. This study concluded that empiric therapy for clinically diagnosed neonatal septicemia should cover both Gram-negative and Gram-positive organisms. Hence, the combination of one antibiotic from each of the following two groups, (1) Imipenam/piperacillin/cefotaxime and (2) amikacin/gentamicin/netilmicin, can be included as an initial therapy for neonatal septicemia.
Authors and Affiliations
H Apabi, K H Paikhomba, J Touthang, P Arun, L Braja Mohon
Keywords
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