Five year trend of aerobic bacteria isolated from patients with neonatal sepsis in a tertiary care centre, North Kerala, India

Background: Antimicrobial resistance has reached to a significant proportion globally. This antimicrobial resistance increases the cost of health care in addition to the existing burden of the prevalence of infectious disease in developing countries. We need to have institutional protocols based on the standard guidelines. It is important for the clinician to use antibiotics only when it is necessary. Thus, the present study was undertaken to know the bacteriological profile and antibiogram of aerobic pathogens isolated from blood samples of patients in NICU during 2012 -2016.Methods: This retrospective study was conducted at Clinical Microbiology and Paediatric department, MES Medical College, Perinthalmanna, between January 2012 to December 2016. All blood samples from suspected Neonatal sepsis were included in the study. The positive samples were cultured as per standard microbiological procedure and antimicrobial susceptibility was done as per CLSI guidelines.Results: During the study period of 5 years, out of 2022 blood samples received from NICU 251 (12.41%) were positive. During the study period, male patients (146, 58.17%) were more than the female. The Gram-positive isolates accounted for 135 (53.78%) isolates compared to Gram negative isolates 115 (45.81%). Authors had a single isolate of Candida species in 2014. Among the Gram positive isolates, Staphylococcus aureus (77/135) was the commonest and Klebsiella pneumoniae (51/115) among the Gram negative isolates. There was a steady rise in MRSA isolation rate in five years. The commonly used antibiotic in neonatal sepsis i.e., Ampicillin and Gentamicin, was observed to have high level of resistance. No resistance was observed against Vancomycin, Teicoplanin, Linezolid among Gram positive and against Carbapenems among Gram negative pathogens.Conclusions: As Gram positive organisms were the most common pathogen isolated in patients with neonatal septicaemia in our study population. The Staphylococcus aureus and Klebsiella pneumoniae were the common isolates. Following this study, Piperacillin tazobactum is considered as the drug for empirical therapy. Vancomycin and carbapenems are considered as reserve drug and escalated only following the report from microbiology report.

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Alarming Pattern of Antimicrobial Resistance in Neonatal Sepsis Observed in Neonatal Intensive Care Unit of a Tertiary Care Hospital in Bangladesh

KYAMC Journal ◽

10.3329/kyamcj.v12i1.53359 ◽

2021 ◽

Vol 12 (1) ◽

pp. 3-7

Author(s):

Tania Rahman ◽

Sharmeen Sultana ◽

Taslima Akber Happy ◽

Kamrunnahar Alo ◽

Momtaz Begum

Keyword(s):

Antimicrobial Resistance ◽

Neonatal Sepsis ◽

Antimicrobial Agents ◽

Tertiary Care ◽

Diffusion Method ◽

Gram Negative Bacteria ◽

Care Hospital ◽

Isolation And Identification ◽

Gram Positive ◽

Gram Negative

Background: Resistance of micro-organisms to multiple broad-spectrum antimicrobial agents is a major problem in treating neonatal sepsis. It is a matter of utmost importance to have knowledge of trends in changing pattern of antimicrobial resistance. Objective: This study was done to observe antimicrobial resistance of gram-positive and gram-negative bacteria isolated from cases of neonatal sepsis Material and Methods: This cross sectional descriptive study was conducted in Department of Microbiology in collaboration with Department of Neonatology, Dhaka Medical College Hospital, Dhaka. Antimicrobial resistance of all the isolated bacteria was performed by Modified Kirby-bauer disk diffusion method following standard guideline after isolation and identification of bacteria from blood samples of suspected septicemic neonates by automated blood culture and standard microbiological protocol. Results: All of the isolated Staphylococcus aureus, Coagulase negative Staphylococcus, Group-B Streptococcus and Micrococcus showed 100% resistance to ceftriaxone, cefotaxime and ceftazidime. Among the isolated gram-negative bacteria, all of Enterobacter spp., Pseudomonas aeruginosa and Citrobacter spp. showed 100% resistance to amoxiclav, amikacin, ceftriaxone, cefixime, ceftazidime. Conclusion: Majority of the gram-positive and gram-negative bacteria are developing resistance to multiple antimicrobial agents and surveillance is necessary to tackle this alarming situation. KYAMC Journal.2021;12(01): 03-07

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Neonatal septicemia isolates and resistance patterns in a tertiary care hospital of North India

The Journal of Infection in Developing Countries ◽

10.3855/jidc.625 ◽

2009 ◽

Vol 4 (01) ◽

pp. 055-057 ◽

Cited By ~ 16

Author(s):

Neelam Kaistha ◽

Manjula Mehta ◽

Nidhi Singla ◽

Ritu Garg ◽

Jagdish Chander

Keyword(s):

Tertiary Care ◽

North India ◽

Care Hospital ◽

Tertiary Care Centre ◽

Gram Positive ◽

Klebsiella Species ◽

Neonatal Septicemia ◽

Blood Samples ◽

Gram Negative ◽

Mortality And Morbidity

Background: Septicemia continues to be a major cause of neonatal mortality and morbidity worldwide. Methodology: To know the rate of neonatal septicemia in our tertiary care centre, a retrospective analysis of 2,247 blood samples was done over a period of four years and three months (July 2003 to October 2007). Results: During that period, a total of 296 (13.17%) blood samples were found to be positive for bacterial isolates. Gram-negative septicemia (80.40%) was identified in more cases than Gram-positive septicemia (20.60%) with Klebsiella species 84 (28.3%) being the most common isolate. Maximum resistance among Gram-negative organisms was seen in amoxycillin/ampicillin and third-generation cephalosporins. Amikacin, cefoperazone/sulbactam and imipenem were found to be good alternative drugs. Among Gram-positive organisms, all strains were sensitive to Vancomycin. Conclusion: Continued surveillance for various pathogens and their susceptibility profile should be done to effectively and timely treat the patients of neonatal septicaemia.

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Emerging Antimicrobial Resistance Among Methicillin Resistant Staphylococcus Aureus (MRSA) in a Tertiary Care Centre in North India

JMS SKIMS ◽

10.33883/jms.v23i1.747 ◽

2020 ◽

Vol 23 (1) ◽

pp. 48-49

Author(s):

Javaid Ahmad Bhat ◽

Shariq Rashid Masoodi

Keyword(s):

Staphylococcus Aureus ◽

Antimicrobial Resistance ◽

Tertiary Care ◽

Resistance Mechanisms ◽

North India ◽

Global Public Health ◽

Care Centre ◽

Tertiary Care Centre ◽

Effective Prevention ◽

Mupirocin Resistance

Apropos to the article by Dr Bali, titled “Mupirocin resistance in clinical isolates of methicillin-sensitive and resistant Staphylococcus aureus in a tertiary care centre of North India” (1), the authors have raised important issue of emerging antimicrobial resistance (AMR). Antimicrobial resistance is an increasingly serious threat to global public health that requires action across all government sectors and society. As per WHO, AMR lurks the effective prevention and management of an ever-increasing spectrum of infections caused by bacteria, parasites, fungi and viruses. Novel resistance mechanisms are emerging and spreading globally, threatening the man’s ability to treat common infectious diseases.

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Changing Trends of Antimicrobial Resistance in Neonatal Sepsis: Experience from a Tertiary Care Hospital from West Bengal, India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/49015.15136 ◽

2021 ◽

Author(s):

Manjula Dutta ◽

Piyali Mitra ◽

Shankha Subhra Nag ◽

Abhijit Dutta

Keyword(s):

Staphylococcus Aureus ◽

Klebsiella Pneumoniae ◽

Acinetobacter Baumannii ◽

Neonatal Sepsis ◽

West Bengal ◽

Tertiary Care ◽

World Health ◽

Klebsiella Pneumonia ◽

High Degree ◽

Very High

Introduction: Sepsis is the second leading cause of neonatal mortality in India. Emergence of highly resistant microorganisms as an aetiology of neonatal sepsis is a matter of serious concern. Aim: To study the prevailing aetiological agents in neonatal sepsis and their antimicrobial susceptibility pattern. Materials and Methods: A prospective observational study was performed in a tertiary care teaching hospital in neonatal care units in North Bengal Medical College and Hospital, West Bengal, India, over a period of two years from March 2017 to February 2019. All the neonates having clinical features suggestive of sepsis were subjected to blood culture using BacT/ALERT® PF Plus. Microbial identification and antibiotic susceptibility testing was done by VITEK-2 automated systems. Chi-square test was done using Epi info software version 7.1 and p-value <0.05 was considered significant. Results: Out of 403 neonates investigated for suspected sepsis, 156 (38.7%) were found to be culture positive. Klebsiella pneumoniae was the most common organism isolated (n=90, 57.7%) followed by Staphylococcus aureus (n=24, 15.4%) and Acinetobacter baumannii (n=10, 6.4%). Klebsiella pneumoniae showed a very high degree of resistance to ampicillin, amoxycillin- clavulenic acid (100% each), cefotaxime (93.4%), ceftazidime (92.3%), gentamycin (94.5%) and tobramycin (94.5%). High resistance of Staphylococcus aureus was seen against ampicillin (100%), cloxacillin (62.5%), amoxicillin-clavulenic acid (70.9%), and cefotaxime (79.2%). Few isolates of Klebsiella pneumonia (6.6%), Acinetobacter baumannii (60%) and Enterobacter cloacae (50%) were sensitive only to colistin and tigecycline. Conclusion: Most of the isolates showed very high degree of resistance against first line of antibiotics recommended by World Health Organisation (WHO) (ampicillin and gentamycin or amikacin) for empirical treatment of neonatal sepsis. Emergence of highly resistant organisms sensitive only to colistin and tigecycline should be considered as an eye opener. Strict adherence to sepsis prevention along with regular surveillance of organisms and their sensitivity patterns is the need of the hour to improve survival by contributing to antibiotic stewardship.

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1439. High Rates of Drug Resistance in Escherichia coli from a Pilot Antimicrobial Resistance Surveillance System in Cambodia

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1620 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S723-S724

Author(s):

Vandarith Nov ◽

Darapheak Chau ◽

Chhorvann Chhea

Keyword(s):

Public Health ◽

Escherichia Coli ◽

Staphylococcus Aureus ◽

Antimicrobial Resistance ◽

Blood Culture ◽

Klebsiella Pneumoniae ◽

Surveillance System ◽

Methicillin Resistance ◽

Salmonella Typhi ◽

Blood Samples

Abstract Background Antimicrobial resistance (AMR) is a major and growing global public health problem. The Cambodia Ministry of Health established a pilot laboratory-based AMR surveillance system for blood specimens in 2017. The objective of this study is to characterize AMR among pathogenic isolates from blood samples. Methods A retrospective analysis was performed using one year of data from a pilot AMR Surveillance system in Cambodia. Four blood culture isolate pathogens were included: Escherichia coli, Klebsiella pneumoniae, Salmonella Typhi /Salmonella Paratyphi A and Staphylococcus aureus. Blood culture isolates that were referred from eleven sentinel sites were analyzed at the National Public Health Laboratory for identification. Antibiotic susceptibility testing (AST) was done using disk diffusion, minimum inhibitory concentration method following Clinical Laboratory Standard Institute (CLSI) guidelines. Results Among 214 pathogenic isolates from blood samples, E.coli was the most common (56.1%), followed by Salmonella Typhi/Salmonella Paratyphi A (18.7%), Staphylococcus aureus (13.5%), and Klebsiella pneumoniae (11.7%). Methicillin Resistance Staphylococcus aureus (MRSA) was detected in half of the isolates. E.coli was resistant to ampicillin (94.4%), trimethoprim-sulfamethoxazole (84.5%), and ceftriaxone (79.2%). Salmonella Typhi was resistant to ampicillin (73.3%) and trimethoprim-sulfamethoxazole (60.0%) and Salmonella Paratyphi A were resistant to fluoroquinolones (91.7%). For last resort antibiotics, E.coli was resistant to carbapenem groups (3.2% for imipenem, 4.9% for meropenem, and 5.0% for ertapenem). Klebsiella pneumoniae was not resistant to any groups. Conclusion E.coli was found at high rates in blood samples and was resistant to common antibiotics used in Cambodia. These pilot data show the importance of establishing a national AMR surveillance system in Cambodia to monitor AMR trends following GLASS guidelines. Disclosures All Authors: No reported disclosures

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Aerobacterial Vaginosis among Women Attending an Infertility Clinic at a Tertiary Care Hospital in Chennai, India and Susceptibility Pattern of Isolates

Journal of Pure and Applied Microbiology ◽

10.22207/jpam.15.1.14 ◽

2021 ◽

Author(s):

Abigail R. Sopia ◽

Pushpa Innocent D. Joseph ◽

M. Kalyani ◽

B. Ananthi ◽

Suresh Dhanaraj ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Tamil Nadu ◽

Tertiary Care ◽

Diffusion Method ◽

Gram Negative Bacteria ◽

Care Hospital ◽

Susceptibility Pattern ◽

Protein Synthesis Inhibitors ◽

Gram Positive ◽

Gram Negative

Genital infections and subsequent vaginosis diagnosed through high vaginal swab in women is caused due to fungi or bacteria. The presented study focused on determining the types, numbers and antibacterial susceptibility pattern of aerobic bacteria causing vaginosis in 147 female patients attending infertility centre in Chennai, Tamil Nadu, India. Candida spp. caused 17% of infections with 15.7% of vaginosis caused by E.coli, Klebsiella spp., Acinetobacter spp., Citrobacter spp. and Gram positive cocci – Methicillin Sensitive Staphylococcus aureus (MSSA), Coagulase Negative Staphylococci(CONS), Staphylococcus aureus and Enterococcus spp. causing 12.9% of vaginitis in the study population. A total of 20 different antibiotics – cell wall inhibitors, protein synthesis inhibitors and nucleic acid synthesis inhibitors; were tested to determine the response of bacterial isolates by Kirby-Bauer disc diffusion method. The study result determined that the most effective drug for treating Gram positive bacterial vaginitis as per CLSI guidelines based on susceptibility pattern as: Linezolid(100%), Gentamycin(91.6%), Amikacin(87.5%),Erythromycin(79.2%), Co-Trimoxazole(72.2%), Ciprofloxacin(65.6%) and least Chloramphenicol(44.3%). High level gentamycin(83.3%) was found to be effective in treating Enterococci. The descending order of susceptibility of Gram negative aerobacteria causing vaginitis as per CLSI guidelines are: Amikacin(87.5%), Gentamycin(82.5%), Cefoperazone sulbactam (76.3%), Ciprofloxacin(68.5%), Ceftazidime(62.5%) and least Amoxyclav(25%).All Gram negative bacteria tested were susceptible to– Imipenem and Meropenem as well as Chloramphenicol. Ceftriaxone (87.5%) and Nitrofurantoin(72.3%) among other antibiotics was effective against Gram negative bacteria while all Enterobacteriaceae members were found to be resistant to tetracycline.

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Neonatal Bacterial Sepsis and Its Susceptibility Pattern in Neonatal Care Unit of Tertiary Care Hospital

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2020/v32i2530828 ◽

2020 ◽

pp. 106-111

Author(s):

Abdul Hameed Tunio ◽

Delijan Mugheri ◽

Muhammad Khan ◽

Wasim Sarwar Bhatti ◽

Abdul Majeed Soomro ◽

...

Keyword(s):

Neonatal Sepsis ◽

Large Scale ◽

Tertiary Care ◽

Research Work ◽

Antibiotic Sensitivity ◽

Resistance Pattern ◽

Care Hospital ◽

Gram Positive ◽

Gram Negative ◽

Gram Positive Bacteria

Background: The drug resistance and pathogens are different in various Hospitals of any country. Very high resistance pattern is observed nowadays to the frequently used antibiotics. The important observation has been noted that most of the doctors do not obtain blood cultures before start of the antibiotics, which becomes competent source of resistance. For the same purpose, this study has been done to find out the responsible microbes causing ailment and their susceptibility towards antibiotics to plan early and effective management. Materials and Methods: A number of 100 new borns admitted in the NICU CMC Children Hospital Larkana with signs and symptoms of sepsis were included in this research work. The study will help in provision of a comprehensive record on microorganisms causing sepsis in the neonates and their antibiotic sensitivity. The epidemiology and presence of neonatal sepsis in particular area makes it more easy and convenient to implement the rationale of empirical antibiotic strategy. Results: From100 neonatal blood samples taken for culture, only 21 proved to be positive which stands 21%. In majority gram positive bacteria were found in (85.71%=18 cases) and gram negative bacteria stood (14.28%=3 cases).Staphylococcus species were found on the large scale (52.38%=11 cases) secondly Streptococcus species (33.33%=7 cases) and the remaining were Escherichia species being least common (14.28%=3 cases). Conclusion: Staphylococcus species provided major share as gram positive bacteria and Escherichia species were found to be major gram negative bacterial population responsible for neonatal sepsis. Profound resistance pattern is seen against widely used antibiotics. It is mandatory to have a routine check over the antibiotic resistance.

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Bacteriological profile of surgical site infections in a tertiary care hospital of western Nepal

Journal of Gandaki Medical College-Nepal ◽

10.3126/jgmcn.v14i1.32703 ◽

2021 ◽

Vol 14 (1) ◽

pp. 33-38

Author(s):

Dharm Raj Bhatta ◽

Abhijit Adhikari ◽

Jampa Lhamo Gurung ◽

Niroj Man Amatya ◽

Niranjan Nayak ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Tertiary Care ◽

Surgical Site Infections ◽

Multidrug Resistant ◽

Care Hospital ◽

Gram Positive ◽

Acinetobacter Species ◽

Gram Negative ◽

Resistance Patterns ◽

Microbiological Techniques

Introduction: Surgical site infections are one of the most commonly reported nosocomial infections resulting into significant morbidity and mortality. Hospital admission and surgical procedures increase the risk of infection with multidrug resistant pathogens. This study was aimed to determine the bacterial agents associated with surgical site infections and antibiotic resistance patterns of the isolates. Methods: A total of 161 specimens from patients with surgical site infections were included in this study. Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques. Results: Out of 161 samples, 94 bacterial isolates were recovered. Gram positive bacteria were isolated in 57.4% (54/94) cases and Staphylococcus aureus was the most common organism (49/54) with 65.3% (32/49) methicillin resistant Staphylococcus aureus isolates. All S. aureus isolates were susceptible to vancomycin. Gram negative bacteria constituted 42.6% (40/94) of total isolates and Escherichia coli was the commonest organism (13/40). Majority of Gram negative isolates were susceptible to amikacin, imipenem and piperacillin-tazobactam. Resistance to imipenem was detected among isolates of E coli, Pseudomonas and Acinetobacter species. Conclusion: Gram positive isolates were more commonly associated with surgical site infections. High percentage of MRSA was detected among the S. aureus isolates but no vancomycin resistant S. aureus. High percentage of Gram negative isolates was susceptible to imipenem, piperacillin-tazobactam, amikacin and gentimicin.

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Bacteriological Profile and their Susceptibility Pattern in Neonatal Intensive Care Unit at Tertiary Care Hospital in Wah

Journal of Rawalpindi Medical College ◽

10.37939/jrmc.v24i3.1310 ◽

2020 ◽

Vol 24 (3) ◽

pp. 219-224

Author(s):

Saba Mushtaq ◽

Sohail Ashraf ◽

Lubna Ghazal ◽

Rida Zahid ◽

Basharat Hussain ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

Gram Negative Bacteria ◽

Gram Positive ◽

Blood Samples ◽

Gram Negative ◽

Gram Positive Cocci

Introduction: Neonatal sepsis is a clinical syndrome characterized by multiple symptoms and signs of infection during the first month of life. The objective of this study is to determine the frequency of commonly isolated bacteria from patients of neonatal sepsis and their susceptibility patterns in POF hospital at Wah. Methods: This cross-sectional study was carried out in POF Hospital Neonatal intensive care unit and Microbiology laboratory from January 2018 to December 2019. The blood samples of patients suspected with neonatal sepsis were processed as per standard methodology. Results: Out of ninety blood samples, fifty-one (56.7%) yielded the growth of Gram-negative rods and thirty-nine (43.3%) yielded Gram-positive cocci. Among Gram-positive bacteria, coagulase-negative staphylococci were the most common pathogen isolated from 53.8% cases followed by methicillin-resistant Staphylococcus aureus (15.3%). Among Gram-negative bacteria, Klebsiella pneumoniae (54.90%) was the most frequently identified bacteria followed by Serratia marcescens (27.45%). The Gram-positive cocci were the most susceptible to linezolid (100%) followed by vancomycin (87.2%). The Gram-negative rods depict remarkable resistance to ciprofloxacin (92.2%), gentamicin (100%), and meropenem (54.9%). Conclusions: The study concluded a predominance of Gram-negative bacteria as a causative agent of neonatal sepsis in our setup. The bacterial isolates are highly resistant to commonly prescribed oral as well as injectable antibiotics. Implementation of infection control policies is a dire need to combat the grave situation of increasing antibiotic resistance.

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Blood culture positive sepsis and sensitivity pattern in a tertiary care neonatal centre in eastern India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20190686 ◽

2019 ◽

Vol 6 (2) ◽

pp. 487

Author(s):

Soumini Rath ◽

Santosh Kumar Panda ◽

Manas Kumar Nayak ◽

Deepti Damayanty Pradhan

Keyword(s):

Blood Culture ◽

Neonatal Sepsis ◽

Early Onset ◽

Tertiary Care ◽

Neonatal Care ◽

Care Practice ◽

Klebsiella Pneumonia ◽

Gram Positive ◽

Gram Negative ◽

Culture Positive

Background: The objective of this study is to evaluate sensitive pattern of causative organisms of neonatal sepsis with its clinical outcome in a tertiary neonatal care unit of eastern India.Methods: This retrospective observational cohort study was done in a tertiary care hospital of Odisha. All the blood culture positive neonatal sepsis cases, excluding neonates with multiple congenital malformations, diagnosed during January 2017 to December 2018 were analysed using descriptive summary statistics.Results: A total of 73 neonatal sepsis cases were diagnosed by BacT/Alert and VITEK-2 blood culture method. Among them, 50 (68%) babies had gram negative sepsis,14 (19%) cases of gram-positive sepsis and nine (13%) cases of fungal sepsis. In present study 38 (52%) cases were early onset sepsis, 38(52 %) babies were term, 55(75%) were male and 44 (60%) babies were out born. Klebsiella pneumonia and Acinetobacter were the most common organism in early onset and late onset sepsis respectively. Among gram negative organism (GNB), 66% were multi drug resistant. A fifty percent of gram-negative organism were sensitive to meropenem and 28% were sensitive to piperacillin/tazobactam. The sensitivity of GNB to colistin, ciprofloxacin, amikacin was 76%, 64% and 56% respectively. The sensitivity of gram-positive organisms to linezolid, vancomycin, teicoplanin and penicillin were 92%, 85%,85% and 20% respectively. Survival rate among culture positive sepsis was 83%.Conclusions: Multi drug organisms are emerging in modern neonatal care practice. Practice of antibiotic stewardship may save the babies from multidrug resistance organism in future.

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