Changing Trend of Neonatal Septicemia and Antibiotic Susceptibility Pattern of Isolates in Nepal

BACKGROUND: Neonatal septicemia is one of the most common leading reasons for neonatal morbidity and mortality in developing countries. Frequent monitoring on pathogens with recent updates and their antimicrobial sensitivity pattern is mandatory for the better treatment. The aim of the study was to determine the bacteriological profile of neonatal septicemia and their antibiotic susceptibility pattern. METHODS: This was a cross-sectional study conducted in Outpatient Department (OPD), Neonatal Intensive Care Unit (NICU), and Pediatrics Ward of Chitwan Medical College Teaching Hospital (CMCTH), Bharatpur, Nepal. Blood cultures were performed on all suspected neonates attending to the hospital with a clinical analysis of neonatal septicemia. Isolated organism was identified by the standard microbiological protocol and antibiotic sensitivity testing was done by Kirby-Bauer disk diffusion method. RESULTS: Out of 516 specimens, bacterial growth was obtained in 56 specimens (10.8%). Prevalence of early onset sepsis was higher 35 (62.5%) in neonates compared to late onset sepsis 21 (37.5%). Majority of neonatal septicemia were caused by gram-negative isolates 39 (69.6%). Acinetobacter species 18 (32.1%) was most commonly isolated organism followed by Staphylococcus aureus 11 (19.6%). The predominant isolate in early onset septicemia was Acinetobacter species 18 (32.1%) and Staphylococcus aureus 9 (16%) and in late onset septicemia was Staphylococcus aureus 11 (19.6%) and Acinetobacter species 5 (8.9%). Staphylococcus aureus and coagulase-negative Staphylococci displayed highest susceptibility towards vancomycin, amikacin, teicoplanin, and meropenem. Gram-negative isolates showed susceptibility towards amikacin, piperacillin/tazobactam, meropenem, ofloxacin, and gentamicin. CONCLUSIONS: Acinetobacter species and Staphylococcus aureus remain the most predominant organisms responsible for neonatal septicemia in a tertiary care setting and demonstrate a high resistance to the commonly used antibiotics. Above all, since the rate of Acinetobacter species causing sepsis is distressing, inspiring interest to control the excess burden of Acinetobacter species infection is mandatory.