Microbial profile and Antibiogram of neonatal septicemia at a tertiary care hospital in Bangalore

Introduction: Neonatal septicemia is the leading cause of neonatal mortality and morbidity in India.The bacteriological profile of neonatal septicemia has changed from time to time and from place to place over the years Objective: Isolation and identification of pathogens responsible for neonatal septicemia from the blood with their antibiotic susceptibility pattern. Materials and methods: Blood samples from clinically suspected neonatal septicemic cases were subjected to aerobic culture and isolates obtained were tested for antibiotic susceptibility pattern as per CLSI guidelines from September 2012 to August 2013 Results: Out of 1129 blood samples studied, 263 (23.29%) were blood culture positive. 161 (61.2%) were males.182 (69.3%) were preterm. Early onset septicemia was seen in 60.9% of cases. Gram negative organisms were predominant in 154 (58.5%), Gram positive organisms in 75 (28.5%), of cases. Klebsiella species and Escherichia coli were isolated in 50 % and 14.8% of cases respectively. MRSA was the major gram positive bacteria with 48 (64%). 22 (8.3%) were Candida isolates confirmed by repeat culture, 21(95.4%) were non albicans Candida species. Majority of gram negative isolates were susceptible to ceftazidime, piperacillin tazobactum and Gram positive isolates showed high resistance to Penicillin, erythromycin, ciprofloxacin. 51 (66.1%) and 32(41.6%) of Klebsiella isolates showed ESBL and MBL production respectively, majority of which were from early onset septicemia. Conclusion: In view of the changing spectrum of the causative agents of neonatal septicemia and their antibiotic susceptibility patterns from time to time, periodic review of cases to assess any changing trends in the infecting organisms and their antimicrobial susceptibility is important.