Bacteriological Profile of Sepsis among Low Birth Weight Neonates: A Hospital-based Cross-sectional Study from Northern India

Introduction: Septicaemia in neonates is characterised by the generalised bacteriological infection which is characterised with a blood culture positivity after 28 days of birth along with clinical presentation of systemic infection. It is one of the common causes of death among Low Birth Weight (LBW) neonates. Incidence of sepsis varies based on different variables, such as hospitals, obstetric and nursing procedures, gender, period of gestation, weight of the baby at birth, place of delivery status, mother’s health and nutrition and perinatal care.

Aim: To know the bacteriological profile and antibiotic susceptibility patterns of organisms causing sepsis in LBW neonates.

Materials and Methods: This cross-sectional hospital-based observational study was conducted in tertiary care hospital, Moradabad, Western Uttar Pradesh, India. LBW newborns (Birth weight <2.5 kg) hospitalised in the Neonatal Intensive Care Unit (NICU) over a period of one year from June 2019 to May 2020 with a diagnosis of clinical sepsis were enrolled. Relevant investigations and treatment were started as per our NICU protocol. Data was entered sequentially in Microsoft Excel spreadsheet and analysed in Statistical Package for the Social Sciences (SPSS) (version 20.0) using Chi-square test.

Results: During the study period, total 145 LBW neonates were admitted in NICU. Out of whom, 83 neonates were admitted with clinical sepsis. A 87.9% of LBW neonates were preterm. Blood culture reports were positive in 30 (36.2%) LBW neonates. In culture proven sepsis, 20 (67%) neonates had early onset neonatal sepsis and 10 (33%) had late onset neonatal sepsis. In culture proven early onset neonatal sepsis, 13 (65%) LBW neonates had gram negative sepsis and 7 (35%) had gram positive sepsis. The most frequently isolated organisms were Acinetobacter baumannii (23.3%) and Klebsiella pneumoniae-(16.7%). These organism were resistance to cefotaxime, ampicillin, amikacin and ciprofloxacin.

Conclusion: Acinetobacter sepsis in LBW neonates is surging rapidly and is associated with high degree of Antimicrobial Resistance (AMR). Therefore, knowledge and awareness of multidrug resistant organism causing sepsis in LBW neonates and their latest antimicrobial sensitivity pattern is essential to choose most appropriate antibiotics.