Extended Spectrum β Lactamase Producing Lactose Fermenters Causing Neonatal Septicaemia in a Tertiary Care Center in Uttar Pradesh
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 4
Abstract
Introduction: Extended-spectrum Beta-lactamase (ESBL) producing enterobacteriaceae are of escalating concern in today’s antibiotic era especially in neonatal sepsis. This study was conducted to determine the prevalence of ESBL producing E.coli and Klebsiella species in neonatal sepsis. Material and Methods: This cross sectional study included 382 samples with signs and symptoms of neonatal sepsis. Blood cultures were done and the isolates were identified using standard biochemical tests and antibiotic susceptibility testing was performed by Kirby Bauer method. Betalactamase productions of the isolates were tested by combined disc diffusion test. Results: Out of 382 samples, 124 (32.46%) samples [males were n=78/227 (34.36%) and 46/155 (29.67%) in females] were culture positive. The culture positivity among the Early Onset Neonatal Sepsis and Late Onset Neonatal Sepsis cases were 47.38% (n=59/124) and 52.42% (n=65/124).; The most common risk associated factors were premature birth, low birth weight, caesarian section etc among EONS and Low birth weight, premature birth, invasive procedures etc among LONS. Among the etiological agents, Staphylococcus aureus (n=24/47) (51.06%) and Coagulase negative Staphylococci (CoNS) (n=14/47) (29.79%) were most frequently isolated among Gram positive and Escherichia coli (n=30/73) (41.09%) followed by Klebsiella species (n=23/73) (31.51%) among the Gram negative isolates. ESBL production was seen in n=24/53 (45.28%) isolates [Escherichia coli n=13 (54.17%) and Klebsiella species n=11 (45.83%)]. Colistin and Imipenem are the most sensitive antibiotics for Escherichia coli and Klebsiella species. Conclusion: High prevalence of ESBL producing E.coli and Klebsiella species was recorded among neonatal septicaemic cases. Testing of ESBL should be regularly done to formulate the empirical therapy based on region.
Authors and Affiliations
Prem P Mishra, Dakshina Bisht, Ved Prakash, Anil Kumar, Varun Goyal
Keywords
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