Neonatal septicemia and current scenario of antibiotic sensitivity pattern – A study of blood culture isolates in a tertiary care hospital, Rajkot

Neonatal sepsis is one of the leading causes of neonatal mortality in developing countries. Neonatal sepsis can be classified into two subtypes depending upon onset of symptoms- before 72 hours of life (early-onset neonatal sepsis—EONS) or later (late-onset neonatal sepsis—LONS). Bacteriological profile and antibiotic susceptibility pattern in neonatal septicemia are changing time-to-time and place-to-place. This study is aimed to know the current scenario of neonatal septicemia and antibiotic susceptibility pattern for determining effective treatment, hence reducing burden of antibiotic resistance.This is a Retrospective study. Data was collected from Bacteriology lab, PDUMC Rajkot (May 2020 – May 2021). Blood cultures were performed on suspected neonates. Both BACTEC and conventional methods were used. Organisms were isolated by standard microbiological protocols and antibiotic sensitivity was performed by Kirby-Bauer disc diffusion method as per CLSI- 2020/2021 guidelines. Total 1402 samples were screened. 326 were positive (23.25%). 214(65.64%) were male and 112(34.36%) were female. CONS (32.21%) was found to be the predominant pathogen followed by Klebsiella (19.63%), Staphylococcus aureus (18.10%), E. coli (15.95%), Acinetobacter (12.27%) and Enterococcus spp. (1.84%). EONS was seen in 195(59.82%) cases and LONS was seen in 131(40.18%) cases. Gram-negative bacteria are predominant in EONS (76.28%) and gram-positive bacteria is predominant in LONS (64.12%). Gram negative isolates are mostly susceptible to Meropenem, Piperacillin-tazobactam, Cefepime, Ceftazidime. Gram positive isolates mostly showed sensitivity to Vancomycin, Linezolid.Multi-drug resistant organism are emerging in neonatal septicemia. Strict antibiotic stewardship should be practiced to avoid the upcoming treatment difficulties.

Download Full-text

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

International Journal of Pediatrics ◽

10.1155/2019/3784529 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Sangita Thapa ◽

Lokendra Bahadur Sapkota

Keyword(s):

Staphylococcus Aureus ◽

Early Onset ◽

Antibiotic Susceptibility ◽

Late Onset ◽

Diffusion Method ◽

Susceptibility Pattern ◽

Sensitivity Testing ◽

Antibiotic Susceptibility Pattern ◽

Neonatal Septicemia ◽

Gram Negative

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.

Download Full-text

Bacteriological Study of Wound Infection and Antibiotic Susceptibility Pattern of the Isolates

Nepal Journal of Science and Technology ◽

10.3126/njst.v14i2.10428 ◽

2014 ◽

Vol 14 (2) ◽

pp. 143-150

Author(s):

R KC ◽

A Shrestha ◽

VK Sharma

Keyword(s):

Wound Infection ◽

Antibiotic Susceptibility ◽

Klebsiella Oxytoca ◽

Microbiological Analysis ◽

Susceptibility Pattern ◽

Gram Positive ◽

Bacteriological Study ◽

Antibiotic Susceptibility Pattern ◽

Gram Negative ◽

Staph Aureus

Wound infections result in sepsis, limb loss, long hospital stays, higher costs, and are responsible for significant human mortality and morbidity worldwide. The present study was conducted to isolate and identify the causative organisms of wound infection, to determine the antibiotic susceptibility pattern of the isolates and to study the risk factors for wound infection. The study was conducted for six months in which pus specimens collected from 244 patients were processed to investigate etiological agents using standard technique. Disc susceptibility of bacterial agents were then determined. A total of 244 pus samples were collected and 147 (60.20%) samples showed growth. A total of 150 bacterial isolates were isolated; of which 118 (78.67%) were Gram positive and 32 (21.33%) were Gram negative bacteria. Staphylococcus aureus (72.00%) was most common followed by Escherichia coli (6.67%), Citrobacter freundii (5.34%), Staphylococcus epidermidis (4.00%), Pseudomonas aeruginosa (3.33%), Proteus mirabilis (2.00%), Enterococcus faecalis (1.33%), Acinetobacter spp. (1.33%), Klebsiella oxytoca (1.33%), Klebsiella pneumoniae (1.33%), Streptococcus pneumoniae (0.67%) and Streptococcus pyogenes (0.67%). The most effective antibiotic for Gram positive isolates was Gentamicin (77.97%). For Gram negative isolates (except Ps. aeruginosa), Amikacin (74.07%), for Ps. aeruginosa, Amikacin, Ciprofloxacin, Gentamicin and Ofloxacin each with the susceptibility of 80.00% and for Staph. aureus, Cloxacillin (79.63%) were the most effective antibiotics. Hence, the most common isolate in wound infection was Staph. aureus followed by E. coli. Therefore, routine microbiological analysis of the wound specimens and their antibiotic susceptibility testing is recommended that will guide clinician for treatment of wound infection. DOI: http://dx.doi.org/10.3126/njst.v14i2.10428 Nepal Journal of Science and Technology Vol. 14, No. 2 (2013) 143-150

Download Full-text

Microbiological Profile of Uropathogens and their Antibiotic Susceptibility Pattern in Pediatric Population from A Tertiary Care Hospital in Amritsar, Punjab

International Journal of Current Microbiology and Applied Sciences ◽

10.20546/ijcmas.2021.1011.034 ◽

2021 ◽

Vol 10 (11) ◽

pp. 306-312

Author(s):

Manpreet Kaur Bhatha Loveena Oberoi ◽

Sapna Soneja Anuradha Malhotra ◽

Kamaldeep Singh

Keyword(s):

Staphylococcus Aureus ◽

Antibiotic Susceptibility ◽

Pediatric Population ◽

Age Group ◽

Susceptibility Pattern ◽

Gram Positive ◽

Antibiotic Susceptibility Pattern ◽

Gram Negative ◽

Gram Negative Organisms ◽

Gram Positive Cocci

Urinary tract infection(UTI) is one of the most commonest bacterial infection encountered in the pediatric age group. Early diagnosis is of utmost importance to preserve renal function and reduce long term complications such as renal scarring. The objective of this study was to determine the prevalence of UTI in pediatric population, identify the common uropathogens and study the antibiotic susceptibility pattern of bacterial isolates. Materials and Methods: A retrospective study was carried out in Department of Microbiology, GMC Amritsar for a period of 6 months from 1 Jan 2021 till 30 June 2021 amongst the pediatric patients (1 month-12 years age group) with clinically suspected UTI including both indoor and outdoor patients. Clean catch midstream urine samples received in the laboratory were processed as per the standard microbiological guidelines. Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method as per CLSI guidelines. Results: A total of 549 samples were received and processed during study period from which 164(29.87%) were culture positive. Culture positivity was more prevalent in females (61.58%) than males (38.41%). Gram negative organisms were predominant (74.4%) followed by gram positive cocci (22.56%) and Candida (3.05%). Among gram negative organisms Escherichia coli was most predominant followed by Klebsiella spp., Pseudomonas spp., Acinetobacter spp., Proteus spp. and Citrobacter spp. Among gram positive cocci Staphylococcus aureus was most predominant followed by Coagulase negative Staphylococci and Enterococcus spp. Majority of gram negative bacilli were resistant to fluroquinolones, 3rd generation cephalosporins and co-trimoxazole while nitrofurantoin, piperacillin-tazobactam and gentamicin were most sensitive drugs. Among Staphylococcus aureus, methicillin resistance was seen in 17% isolates. High sensitivity was seen to linezolid and vancomycin in gram positive cocci. Conclusion: This study highlights increased prevalence of MDR uropathogens in pediatric population which indicates that antibiotic selection should be based on knowledge of local prevalence of bacterial organisms and their antibiotic sensitivities with rational use of antibiotics.

Download Full-text

Pattern of bacterial isolates causing neonatal septicemia along with their pattern of antibiotic susceptibility.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.04.3524 ◽

2020 ◽

Vol 27 (04) ◽

pp. 737-741

Author(s):

Shahid Iqbal ◽

Fazal Ur Rehman ◽

Waqas Ali ◽

Sanam Bano Rajper

Keyword(s):

Blood Culture ◽

Antibiotic Susceptibility ◽

Data Entry ◽

Antibiotic Sensitivity ◽

Bacterial Isolates ◽

Candida Spp ◽

Gram Positive ◽

Neonatal Septicemia ◽

Gram Negative ◽

Empiric Antibiotic

Objectives: We planned this study to observe the pattern related to bacterial isolates causing neonatal septicemia along with their pattern of antibiotic susceptibility. Study Design: Prospective study. Setting: Department of Neonatology, Sheikh Khalifa Bin Zaid Al Nahyan Teaching Hospital, Rawlakot. Period: From 1st January 2018 to 30th June 2018. Material & Methods: Prior to empiric antibiotic usage, blood was collected from neonates having clinical sepsis and sent for blood culture. A total of 60 neonates with culture proven sepsis were enrolled for this study. Reports of blood culture were evaluated for isolates of bacteria as well as patterns of sensitivity for frequently used antibiotics in the institution. SPSS version 21.0 was used for data entry and analysis. Results: A total of 60 neonates having culture proven sepsis were enrolled in the current study. Amongst these, 39 (65.0) were male and 21 (35.0%) female. Early onset of sepsis was diagnosed in most, 42 (70.0%) neonates. Majority of neonates, 50 (83.3%) were delivered in the same hospital. Gram negative isolates were found in 43 (71.7%) and 15 (25.0%) gram positive while 2 (3.3%) candida spp. In terms of pattern of antibiotic sensitivity, 4 (9.3%) isolates of gram negative were found resistant to every antibiotic routinely used while gram positive isolates showed excellent sensitivity to vancomycin. Conclusion: Gram negative isolates of organisms were found to be the most sensitive to carbepenems (especially meropenem) as well as aminoglycosides while gram positive isolates showed excellent sensitive regarding vancomycin.

Download Full-text

Evaluation of bacterial pathogens in neonatal sepsis and their susceptibility pattern: A Hospital Based Study

Community Based Medical Journal ◽

10.3329/cbmj.v3i1.53327 ◽

2014 ◽

Vol 3 (1) ◽

pp. 35-40

Author(s):

Biplob Kumar Raha ◽

Nasim Jahan ◽

Md Abdul Baki ◽

Tahmina Begum ◽

Nazmun Nahar ◽

...

Keyword(s):

Neonatal Sepsis ◽

Antimicrobial Agents ◽

Clinical Laboratory ◽

Blood Cultures ◽

Diffusion Method ◽

National Committee ◽

Gram Negative Bacteria ◽

Susceptibility Pattern ◽

Gram Positive ◽

Gram Negative

Neonatal sepsis is one of the major causes of neonatal morbidity and mortality, particularly in developing countries. Epidemiology and surveillance of neonatal sepsis helps in implementation of rational empirical antibiotic strategy. A cross-sectional prospective study was conducted in the special care baby unit under department of Paediatrics and Neonatology, BIRDEM General Hospital during the period of November 2008 to September 2009 to determine the pattern of bacterial agents causing neonatal sepsis and their susceptibility pattern to various antimicrobial agents. Blood cultures were performed on admitted newborn babies (0-28 days) to rule out sepsis. Antimicrobial susceptibility testing was done for all blood culture isolates according to the criteria of the National Committee for Clinical Laboratory Standards by disk diffusion method. Out of 720 screened blood cultures, 64 (8.9%) reported as positive and the gram positive and gram negative bacteria accounted for 6 (9.4%) and 58 (90.6%) respectively. The most common gram positive organisms were Staphylococcus aureus (6.3%) and Enterococci (3.1%) & gram negative organisms were Klebsiella pneumoniae (37.5%), Serratia (25%), Pseudomonas aeruginosa (10.9%), Citrobacter (10.9%) and Acinetobacter (6.3%). The susceptibilities were remarkably low to Ampicillin (3.12 %) & Cefotaxim (10.9%) for both gram positive & gram negative isolates. Gram positive group had susceptibilities of 66.7% to Ciprofloxacin and Imipenem, 83.3% to Gentamicin, & 100% to Amikacin & Vancomycin. Gram negative isolates showed higher sensitivities to Imipenem (94.8%), Ciprofloxacin (89.7%), Amikacin (72.4%) respectively. Gram-negative bacteria showed high level of resistance to commonly used antibiotics (Ampicillin, Ceftazidim and Cefotaxim). Gentamicin, Amikacin, Imipenem and Ciprofloxacin were the most effective drugs compared to others. Routine bacterial surveillance and their sensitivity patterns must be an essential component of neonatal care. CBMJ 2014 January: Vol. 03 No. 01 P: 35-40

Download Full-text

Bacteriological Profile, Antibiotic Susceptibility Pattern and Predictors of bacteremia among Children with Bloodstream Infection

10.21203/rs.3.rs-400910/v1 ◽

2021 ◽

Author(s):

Samina Nazir Chaki ◽

Levina Msuya ◽

Deborah Mchaile ◽

Michael Johnson Mahande ◽

Ronald Mwitalemi Mbwasi ◽

...

Keyword(s):

Escherichia Coli ◽

Staphylococcus Aureus ◽

Bloodstream Infection ◽

Antibiotic Susceptibility ◽

Klebsiella Pneumonia ◽

Gram Negative Bacteria ◽

Susceptibility Pattern ◽

Gram Positive ◽

Antibiotic Susceptibility Pattern ◽

Gram Negative

Abstract Background: Bloodstream infections are major causes of morbidity and mortality among children in Sub-Saharan countries. This study aimed to determine the prevalence of bacteremia, etiological agents’ antibiotic susceptibility pattern and predictors of bacteremia among children with bloodstream Infection.Methodology: This hospital-based cross-section study involved children aged two months to thirteen years. All children meeting the inclusion criteria during the study period were enrolled. All consenting parents were interviewed via a questionnaire to collect data, followed by a thorough physical assessment and venipuncture was done to collect blood samples. Data were analysed using SPSS version 23.Results: Among 242 study participants, 154(63.6%) were male and blood cultures were positive in 37(15.3%). Gram-positive and gram-negative bacteria constituted 32(80%) and 8(20%), respectively. The frequent pathogen found was Staphylococcus aureus 25(62.5%), followed by Enterococcus spp. 4(10%), Escherichia coli 4(10%), Pseudomonas aeruginosa 3(7.5%), Streptococcus pyogenes 3(7.5%) and 1(2.5%) Klebsiella pneumonia. The majority of bacterial isolates showed high resistance to commonly used antibiotics in the study area. Predictors of bacteremia were severe malnutrition, hydrocephalus, hyperglycemia, lethargy and BSI with no foci of infection. Conclusion: Prevalence of bacteremia was 15.3%. Gram-positive bacteria were more prevalent than gram-negative bacteria. Staphylococcus aureus and Escherichia coli were the prevalent isolates causing BSI. Effective antibiotics for both gram-negative & gram-positive organisms are imipenem, meropenem and piperacillin-tazobactam followed by amikacin; vancomycin & clindamycin for gram-positive organisms. To curb the growing antimicrobial resistance that we see in this and other studies, continuous antimicrobial stewardship is necessary, else we risk failing to treat BSI.

Download Full-text

Etiology of bloodstream infection and antibiotic susceptibility pattern of the isolates

Asian Journal of Medical Sciences ◽

10.3126/ajms.v7i2.13444 ◽

2015 ◽

Vol 7 (2) ◽

pp. 71-75 ◽

Cited By ~ 2

Author(s):

Prashubha Bhandari ◽

Sarita Manandhar ◽

Basudha Shrestha ◽

Nabeen Dulal

Keyword(s):

Bloodstream Infection ◽

Antibiotic Susceptibility ◽

Salmonella Typhi ◽

Klebsiella Pneumonia ◽

Gram Negative Bacteria ◽

Susceptibility Pattern ◽

Salmonella Spp ◽

Gram Positive ◽

Antibiotic Susceptibility Pattern ◽

Gram Negative

Background: Bloodstream infection (BSI) is a signifi cant cause of morbidity and mortality. In Nepal, very few studies on BSIs have restricted the understanding of their cause, prevention and treatment. This cross-sectional study was conducted to isolate BSIs causing pathogens and determine their antibiotic susceptibility pattern in patients visiting Kathmandu ModelHospital during December 2012 to May 2013.Materials and Methods: Standard laboratory procedure was used to screen, isolate and identify the bacteria from 1,205 patients. The antibiotic susceptibility pattern (AST) was analyzed by modifi ed Kirby Bauer technique and data were analyzed using SPSS version-16.Results: Out of 1,205 blood samples, 186 (15.4 %) were culture positive. The most common bacteria isolated were: Salmonella spp., Escherichiacoli, Klebsiella pneumoniae and CoNS. Gram-negative bacteria were the predominant causes of BSIs. Salmonella Typhi was isolated in 71 % cases of bloodstream infection followed by Salmonella Paratyphi A in 16 %, Escherichia coli in 5.3 % and Klebsiella pneumonia in 0.5 %. The gram-positive organism responsible for causing BSI was coagulase-negative staphylococcus in 7 % cases. There was no significant association between bacteremia and gender of the patients. During ASTs, Gram-negative bacteria were sensitive to Chloramphenicol with only 0.5 % resistivity. Salmonella Typhi (85.6 % of isolates) showed resistance to Nalidixic acid. Gram-positive bacteria showed 100 % sensitivity towards Chloramphenicol and Gentamicin and were least sensitive to Amoxicillin.Conclusion: Salmonella spp., was major cause of BSIs. Increase in antibiotic resistivity for BSI causing pathogens has necessitated continuous monitoring of the susceptibility of organisms towards antibiotics.Asian Journal of Medical Sciences Vol.7(2) 2015 71-75

Download Full-text

Antibiotic Susceptibility Pattern of Bacterial Isolates from Soft Tissues Infection among Patients Visiting Birendra Military Hospital, Chhauni, Kathmandu

Tribhuvan University Journal of Microbiology ◽

10.3126/tujm.v6i0.26595 ◽

2019 ◽

Vol 6 ◽

pp. 119-126

Author(s):

Kushaalta Giri ◽

Sharada Gurung ◽

Simrika Subedi ◽

Alina Singh ◽

Nabaraj Adhikari

Keyword(s):

Antibiotic Susceptibility ◽

Soft Tissues ◽

Effective Drug ◽

Military Hospital ◽

Gram Negative Bacteria ◽

Bacterial Isolates ◽

Susceptibility Pattern ◽

Gram Positive ◽

Antibiotic Susceptibility Pattern ◽

Gram Negative

Objectives: To determine the rate of soft tissues infection and perform antibiotic pattern susceptibility test of bacterial pathogens isolated from soft tissue infected patients visiting Shree Birendra Hospital, Kathmandu, Nepal. Methods: A total of 380 wound specimens (open and closed) including pus and wound swabs were processed in the laboratory of Birendra Military Hospital, Chhauni from August to November 2018. The specimens were cultured on Blood Agar blood agar and Mac-Conkey agar and incubated at 37°C for 24 hrs. Antibiotic Susceptibility Test was performed by using modified Kirby-Bauer disc diffusion method. Thus, multidrug resistant (MDR) bacteria and methicillin resistant Staphylococcus aureus (MRSA) were differentiated. Results: Out of 380 bacterial isolates, 86(43.21%) were gram positive and 113(56.78%) were gram negative bacteria. Among all the gram-positive isolates 43(53.09%) were found to be MRSA. Similarly, 62(54.86%) were found to be MDR among the gram-negative bacteria. Gentamicin and Amikacin were found to be the most effective drug though the resistance pattern is not homogenous against all isolates. Conclusion: Antibiotic susceptibility pattern of all bacterial isolates showed that, Gentamycin, Amikacin, Levofloxacin, Piperacillin/ Tazobactam, Doxycycline was the effective drug for Gram-negative bacteria and Amikacin, Teicoplanin, Linezolid, Doxycycline, Gentamycin and Azithromycin was the most effective drug for Gram-positive organisms. Thus it can be concluded that these antibiotics may be used for the empirical treatment of soft tissues infection.

Download Full-text