scholarly journals Bacteriological Profile of Neonatal Sepsis in a Tertiary Level Hospital of Nepal

2015 ◽  
Vol 34 (3) ◽  
pp. 175-180 ◽  
Author(s):  
R Khanal ◽  
S Manandhar ◽  
GP Acharya

Introduction: Neonatal sepsis is one of the most common reasons for admission to neonatal units in developing countries. It is also a major cause of mortality in both developed and developing countries. This study was done to determine the bacterial profile causing neonatal sepsis and to assess their susceptibility pattern to various antimicrobial agents. Materials and Methods: A cross-sectional prospective study was conducted in Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal among 340 neonates suspected of neonatal sepsis. Blood culture was performed and organisms were identified with Gram staining and conventional biochemical methods. Antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI). Results: The prevalence rate of neonatal sepsis was 20.3%. Among 340 neonates, 52.17% were males and 47.82% were females. Gram positive cocci were the most predominant isolates (88.40%). Among Gram positive cocci Staphylococcus epidermidis was the most common isolates (72.46%) followed by Staphylococcus aureus (7.24%), Staphylococcus saprophyticus (4.34%) and Enterococcus fecalis (4.34%). Gram negative bacilli were found in 11.60% of the growth positive samples of which E.coli and Klebsiella spp were found in 10.14% and 1.44% respectively. Sensitivity to Amikacin was highest among all types of organisms isolated. Vancomycin and Gentamycin sensitivity was highest for Gram positive and Gram negative organisms respectively. Ampicillin resistance was highest among isolates. Among the 69 isolates 48 were Multiple drug resistant. Conclusion: The predominance of Gram positive cocci particularly Coagulase negative Staphylococci is shown. Empirical antibiotic therapy should be reviewed for Multiple drug resistant strains. DOI: http://dx.doi.org/10.3126/jnps.v34i3.9183 J Nepal Paediatr Soc 2014;34(3):175-180

2017 ◽  
Vol 37 (1) ◽  
pp. 5-9
Author(s):  
Roshan Parajuli ◽  
Narayan Dutt Pant ◽  
Raju Bhandari ◽  
Anil Giri ◽  
Suman Rai ◽  
...  

Introduction: Neonatal sepsis is a serious problem in developing countries like Nepal. The main objectives of this study were to determine the bacteriological profile of neonatal sepsis, to determine the antimicrobial susceptibility patterns of the causative agents and to evaluate the association between the neonatal sepsis and the different characteristics of the neonates.Methods: A hospital based cross-sectional study was conducted among a total of 450 neonates suspected of suffering from sepsis. Blood culture was performed using statdard microbiological techniques. The colonies grown were identified on the basis of colony morphology, Gram’s stain and biochemical tests. The antimicrobial susceptiblility testing was performed by Kirby Bauer disc diffusion method. Results: Out of total 450 blood samples, 92 (20.4%) were culture positive. Of which,  16 (17.4%) samples contained  gram negative bacteria and 76 (82.6%) samples contained gram positive cocci. The most common bacterial pathogens isolated were Staphylococcus epidermidis (67.4%) followed by Escherichia coli (13%). All gram positive cocci were susceptible to vancomycin, while all gram negative bacilli were sensitive to amikacin. There was statistically significant relationship between neonatal sepsis and gestation age of neonates.Conclusions: Neonatal sepsis is still present as a serious problem in Nepal. Staphylococcus epidermidis was the most common cause of the neonatal sepsis. Prematurely delivered neonates should be given more care, as they are more prone to suffering from neonatal sepsis. Vancomycin and amikacin can be used as the drugs of choice for preliminary treatment of neonatal sepsis in our settings.


2019 ◽  
Vol 6 ◽  
pp. 96-102
Author(s):  
Bikrant Gumanju ◽  
Roshna Shrestha ◽  
Poonam Lakhemaru ◽  
Rakysa Upadhyaya ◽  
Sushila Shrestha ◽  
...  

Objectives: The present study aimed to identify bacteria profile of cell phones used by different people from different profession of Bhaktapur and to access their antimicrobial resistance. Methods: Forty-nine mobile swab samples were collected from 7 different profession category (7 samples each from student, butcher, cook, panipuri vendor, health workers, and dairy employee). Samples were cultured and processed by standard Microbiological procedures. All the isolates were further subjected to antibiotic susceptibility testing using modified Kirby Bauer disc diffusion method as describe in CLSI guidelines. The rate of multiple drug resistant (MDR) bacteria was also determined. Results: Out of 49 sample, Bacillus spp (20.4%) was the most predominant isolate, followed by Staphylococcus aureus (10.6%) and Pseudomonas spp (10.6%). Higher variety of bacterial isolates was found in the cell phones swabs from butcher followed by cook, farmer and panipuri vendor group. The data from the questionnaire showed that handkerchief or tissue paper were mostly used by respondents to clean their mobile. All Gram-positive and Gram-negative isolates were resistance to Cefoxitin (100%) except Micrococcus spp and Neisseria spp. Gram positive (18.2%) and Gram-negative (36.9%) isolates were identified as MDR. All S. aureus and Coagulase negative staphylococci were methicillin resistant Conclusion: The Cell phones of people from different profession were found to possess many different bacterial pathogens including multi drug resistant strains which could be the possible pathogens for food borne infections and opportunistic infections.


2014 ◽  
Vol 3 (1) ◽  
pp. 35-40
Author(s):  
Biplob Kumar Raha ◽  
Nasim Jahan ◽  
Md Abdul Baki ◽  
Tahmina Begum ◽  
Nazmun Nahar ◽  
...  

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


2019 ◽  
Vol 2 (1) ◽  
pp. 170-180
Author(s):  
O. O. Oludairo

Multiple drug resistant (MDR) strains of Salmonella are frequently encountered with increased rates in recent years. Many variants of the organism have developed MDR genes which they retain even when antimicrobial drugs are no more in use, limiting the choice of drugs for therapy of Salmonella infections resulting in morbidity and mortality in both man and animals and raising more public health questions. The objective of this study was to evaluate the susceptibility of Salmonella spp. to twelve antimicrobial agents using the disk diffusion method. Eight Salmonella spp. isolated from wildlife were tested. All the isolates exhibited MDR, showing resistance to at least four and up to nine antimicrobial agents. They were all highly resistant (100%) to ceftazidime, cephazoline, cefuroxidine and ampicillin but were susceptible to nalidixic acid and ciprofloxacin. Six resistant patterns were observed, with ampicillin-cefuroxime sodiumcephazolin-ceftazidime and streptomycin-ampicillin-cefuroxime sodium-cephazolin-ceftazidime resistant patterns exhibited by two isolates each. The substantial multiple resistance pointed to the fact that limitations could be faced in choosing drugs for the treatment of Salmonella infections and that mortality and economic losses could be experienced especially if sensitivity tests are not carried out before antimicrobial choice is made for treatments in both man and animals.


KYAMC Journal ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 3-7
Author(s):  
Tania Rahman ◽  
Sharmeen Sultana ◽  
Taslima Akber Happy ◽  
Kamrunnahar Alo ◽  
Momtaz Begum

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


1998 ◽  
Vol 42 (8) ◽  
pp. 2006-2011 ◽  
Author(s):  
Yoichi Hirakata ◽  
Koichi Izumikawa ◽  
Toshiyuki Yamaguchi ◽  
Hiromu Takemura ◽  
Hironori Tanaka ◽  
...  

Gram-negative rods (GNR) carrying the transferable carbapenem resistance gene blaIMP, includingPseudomonas aeruginosa and Serratia marcescens, have been isolated from more than 20 hospitals in Japan. Although the emergence of such multiple-drug-resistant bacteria is of utmost clinical concern, little information in regard to the distribution ofblaIMP-positive GNR in hospitals and the clinical characteristics of infected patients is available. To address this, a system for the rapid detection of theblaIMP gene with a simple DNA preparation and by enzymatic detection of PCR products was developed. A total of 933 ceftazidime-resistant strains of GNR isolated between 1991 and 1996 at Nagasaki University Hospital, Nagasaki, Japan, were screened for theblaIMP gene; 80 isolates were positive, including 53 P. aeruginosa isolates, 13 other glucose-nonfermenting bacteria, 13 S. marcescens isolates, and 1 Citrobacter freundii isolate. Most of the patients from whom blaIMP-positive organisms were isolated had malignant diseases (53.8%). The organisms caused urinary tract infections, pneumonia, or other infections in 46.3% of the patients, while they were just colonizing the other patients evaluated. It was possible that blaIMP-positive P. aeruginosa strains contributed to the death of four patients, while the other infections caused by GNR carryingblaIMP were not lethal. DNA fingerprinting analysis by pulsed-field gel electrophoresis suggested the cross transmission of strains within the hospital. The isolates were ceftazidime resistant and were frequently resistant to other antibiotics. Although no particular means of pathogenesis ofblaIMP-positive GNR is evident at present, the rapid detection of such strains is necessary to help with infection control practices for the prevention of their dissemination and the transmission of the resistance gene to other pathogenic bacteria.


Author(s):  
Madhulika Mistry ◽  
Arpita Bhattacharya ◽  
Twinkle Kumar Parmar

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.


2004 ◽  
Vol 48 (8) ◽  
pp. 2831-2837 ◽  
Author(s):  
Mizuyo Kurazono ◽  
Takashi Ida ◽  
Keiko Yamada ◽  
Yoko Hirai ◽  
Takahisa Maruyama ◽  
...  

ABSTRACT ME1036, formerly CP5609, is a novel parenteral carbapenem with a 7-acylated imidazo[5,1-b]thiazole-2-yl group directly attached to the carbapenem moiety of the C-2 position. The present study evaluated the in vitro activities of ME1036 against clinical isolates of gram-positive and gram-negative bacteria. ME1036 displayed broad activity against aerobic gram-positive and gram-negative bacteria. Unlike other marketed β-lactam antibiotics, ME1036 maintained excellent activity against multiple-drug-resistant gram-positive bacteria, such as methicillin-resistant staphylococci and penicillin-resistant Streptococcus pneumoniae (PRSP). The MICs of this compound at which 90% of isolates were inhibited were 2 μg/ml for methicillin-resistant Staphylococcus aureus (MRSA), 2 μg/ml for methicillin-resistant coagulase-negative staphylococci, and 0.031 μg/ml for PRSP. In time-kill studies with six strains of MRSA, ME1036 at four times the MIC caused a time-dependent decrease in the numbers of viable MRSA cells. The activity of ME1036 against MRSA is related to its high affinity for penicillin-binding protein 2a, for which the 50% inhibitory concentration of ME1036 was approximately 300-fold lower than that of imipenem. In conclusion, ME1036 demonstrated a broad antibacterial spectrum and high levels of activity in vitro against staphylococci, including β-lactam-resistant strains.


2020 ◽  
Vol 24 (3) ◽  
pp. 219-224
Author(s):  
Saba Mushtaq ◽  
Sohail Ashraf ◽  
Lubna Ghazal ◽  
Rida Zahid ◽  
Basharat Hussain ◽  
...  

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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