Hari Prasad Nepal1*, Anju Acharya2, Rajendra Gautam3, Sony Shrestha4, Rama Paudel5
1,3Assistant Professor, 2Associate Professor, 4Lecturer, Department of Microbiology, Chitwan Medical College (CMC) Teaching Hospital; 5Resident, Department of Pharmacology, College of Medical Sciences, Chitwan, Nepal
Background: Neonatal septicemia is an important cause of morbidity and mortality. Knowledge of bacteriological profile and antimicrobial susceptibility is very important for management of such infection.
Objective: To determine the bacteriological profile of neonatal septicemia and the antimicrobial resistance pattern.
Materials and Methods: A total of 377 neonatal blood cultures samples were processed in the Department of Microbiology, Chitwan Medical College Teaching Hospital, Nepal in one year period. Isolation, identification and antimicrobial susceptibility was determined by standard microbiological methods.
Results: Of 377 specimens studied, bacterial growth was obtained in 80 specimens (2.1%). Gram-positive organisms were isolated in 35 (43.7%) and Gram-negative in 45 (56.3%) specimens. Staphylococcus aureus was the most common organism (23/70 isolates) isolated in early-onset septicemica followed by Acinetobacter species (18/70 isolates) and Klebsiella species. However, late-onset septicemia was primarily associated with Acinetobacter species (4/10 isolates).
On performing antimicrobial susceptibility testing, Gram-positive organisms exhibited maximum resistance to Cotrimoxazole (100%) followed by Penicillin (75%) and Cephalexin (50%) while Gram-negative organism to Norfloxacin (100%) followed by Cefixime (90.6%), Cotrimoxazole (80%) and Ceftriaxone (78.5%) among all antibiotics tested.
Conclusion: A wide spectrum of antimicrobial resistant bacterial agents are responsible for neonatal septicemia in our set up. A longitudinal surveillance program coupled with good infection control practices and rational use of antibiotics is important to reduce infection rate and ensure better therapeutic success.
Keywords: Neonatal septicemia, bacteriological profile, antimicrobial resistance, Nepal