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
ABSTRACT
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