Spiraling antimicrobial resistance and bacteriological profile of early onset and late onset neonatal septicemia.

Research Report.

Summary: Septicemia in neonates refers to generalized bacterial infection documented by a positive blood culture in the first 4 weeks of life. Neonatal sepsis remains as an important cause of morbidity and mortality among infants in developing countries accounting for 30-50% of total deaths each year. Sepsis occurring in the first 72 hours of life is defined as early-onset sepsis (EOS) and that occurring beyond 72 hours as late-onset sepsis (LOS). This study was carried out to find the bacteriological profile and their antimicrobial susceptibility pattern in early onset and late onset neonatal septicemia. In this cross-sectional study, blood samples from the suspected infants were collected and processed in the bacteriology laboratory. The growth was identified by standard microbiological protocol and the antibiotic sensitivity testing was carried out by modified Kirby-Bauer disk diffusion method. Among total suspected cases, the septicemia was confirmed in 29 (10.0 %) neonates. Earlyonset septicemia (EOS) was observed in 26 infants and late-onset septicemia (LOS) in 3 infants. Staphylococcus aureus (44.82%) was the predominant Gram-positive organism isolated from EOS as well as from LOS cases followed by Enterococcus species (24.13%). Klebsiella pneumoniae (24.13%) was the predominant Gram-negative organism followed by Acinetobacter species (3.44%). The result of our study reveals that Staphylococcus aureus, Enterococcus spp., and Klebsiella pneumoniae are the most common etiological agents of neonatal septicemia. In particular, since rate of Bacterial sepsis is alarming, prompting concern to curb the excess burden of Bacterial infection is necessary.