Changing pattern of Neonatal septicaemia: An epidemiological study conducted at rural tertiary care hospital of central India
Neonatal septicaemia is major cause of mortality and morbidity among neonates around the world. This is also one of the most common reasons for admission to a neonatal unit in developing countries. Blood culture is gold standard method for diagnosis.
Changing pattern of organisms and frequent emergence of resistant bacteria causes difficulty in treatment of neonatal septicaemia. Pattern of micro-organisms is different for different places at the same time but it is also found to be different at same place at different times.
METHODS:
Study was conducted in AVBR Hospital & Research center, Wardha. All the neonates admitted in NICU with clinically diagnosed neonatal septicaemia were divided in two groups. Group I- those admitted in the year 2009. Group II- those admitted in the year 2012. Blood culture was done in all cases by conventional three subculture method. The data obtained was analysed using Statistical software SPSS 13.0
RESULTS:
As compared to Group I, there was marked reduction in prevalence of neonatal septicaemia in Group II (from 49.05% to 22.45%).
In Group I Klebsiella Pneumoniae was frequently isolated pathogen (63.11%), followed by Escherichia coli (12.62%), Staphylococcus aureus (10.68%) and other (13.59%).
In Group II Staphylococcus aureus was frequently isolated pathogen (29.55%), followed by Klebsiella Pneumoniae (27.27%), Pseudomonas aeruginosa (20.45%) & other (22.73%).
Sensitivity pattern was almost same with Gram negative isolates 100% sensitive to imipenem followed by amikacin and cefotaxime/ceftazidime. Staphylococcus aureus isolates were 100% sensitive to vancomycin followed by amikacin and cloxacillin.
CONCLUSIONS:
As compared with earlier Group I there was marked reduction in septicaemia in Group II. There is change in the predominant causative organisms of Group I and Group II. The change in pathogens over time requires confirmation by ongoing surveillance. An understanding of epidemiology of neonatal septicaemia is vital for developing antibiotic policy for NICU patients.