BACTERIOLOGICAL PROFILE AND ANTIBIOTIC SUSCEPTIBILITY PATTERNS OF ISOLATES IN NEONATAL SEPSIS: A COMPREHENSIVE STUDY
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Keywords
Neonatal sepsis, bacteriological profile, antibiotic resistance, Gram-negative bacteria, Gram-positive bacteria, neonatal intensive care unit, empirical antibiotic therapy, antibiotic stewardship
Abstract
Background: Neonatal sepsis remains a significant cause of morbidity and mortality in newborns worldwide, particularly in developing countries like Pakistan. This condition, marked by systemic infection within the first 28 days of life, demands rapid and effective treatment. The growing trend of antibiotic resistance complicates this approach. Understanding local bacteriological profiles and antibiotic susceptibility patterns is crucial for devising effective treatment protocols.
Objective: The primary objective of this study is to identify the bacteriological profile and antibiotic susceptibility patterns of isolates in neonatal sepsis at Abbasi Shaheed Hospital, Karachi.
Methods: This comprehensive study was conducted at the NICU of Abbasi Shaheed Hospital, Karachi, from January 2023 to June, 2023. We included neonates diagnosed with sepsis based on clinical signs and positive blood cultures. Exclusion criteria included congenital anomalies and those transferred from other hospitals. A total of 178 neonates were enrolled. Blood samples were collected aseptically for culture and sensitivity testing before initiating antibiotics. Data were meticulously collected on baseline characteristics and in-hospital outcomes. Statistical analysis was performed using SPSS software (version 26.0). Continuous variables were expressed as mean ± SD or median with IQR. Categorical variables were presented as frequencies and percentages.
Results: The study revealed that Gram-negative bacteria were the predominant pathogens (58%). Escherichia coli (27%) and Klebsiella pneumoniae (20%) were the most common. Gram-positive bacteria constituted 42%, with Staphylococcus aureus (28%) and Streptococcus species (14%) as primary pathogens. High resistance rates to commonly used antibiotics were observed. E. coli and K. pneumoniae showed significant resistance to ampicillin (85% and 78%, respectively) and gentamicin (55% and 60%, respectively). The analysis identified significant associations between low birth weight, preterm birth, and the incidence of sepsis (p < 0.05).
Conclusion: The study highlights the predominance of Gram-negative bacteria and significant antibiotic resistance in neonatal sepsis at Abbasi Shaheed Hospital. These findings underscore the need for continuous surveillance, reassessment of empirical antibiotic strategies, and robust antibiotic stewardship programs to combat neonatal infections effectively.
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Dr Muhammad Fareeduddin
Consultant Pediatrician, Indus Hospital, Karachi, Pakistan
Dr Atika Sher
Assistant Professor, Liaquat National Hospital and Medical College, Pakistan
Dr Riffat Farrukh
Assistant Professor, Department of Paediatrics, Abbasi Shaheed Hospital, KMDC Karachi, Pakistan;
Dr Farhina Nasir
Demonstrator, Pathology Department, KMDC Karachi, Pakistan
Dr Ibrahim Shakoor
Professor of Paediatrics, Paediatric Department, Abbasi Shaheed Hospital, KMDC, Karachi Pakistan;
Dr Shaheen Masood
Assistant Professor, Paediatrics Department, KMDC & Abbasi Shaheed Hospital Karachi, Pakistan;