Journal of Pure and Applied MicrobiologyVol. 6 No. Special Edition Oct. 2012

Cephalosporin Resistant Gram-Negative Bacteraemia in Neonates in a Tertiary Referral Hospital

Fatima Khan, Fatima Shujatullah, Sana Jamali, Indu Shukla, Parvez Anwar Khan and Nazish Fatima

Departmen of Microbiology, Jawaharlal Nehru Medical College and Hospital, AMU, Aligarh, India.

Received on 04 March 2012 and accepted on 10 June 2012

 

ABSTRACT

Neonatal sepsis is a disseminated disease with positive blood culture during the first month of life and is a common cause of mortality in neonates. The microbial etiology of neonatal sepsis is variable and an increase in sepsis caused by gram negative organisms has been reported in the recent years. The emergence of cephalosporin resistance in gram-negative nosocomial pathogens is a formidable problem, associated with adverse clinical outcomes and increased hospital costs. Methodology: The study was conducted in the Department of Microbiology, JNMCH, AMU, Aligarh between January 2006 to September 2011. Blood culture was done on 1,740 samples received from neonatal intensive care unit (NICU), Department of Paediatrics. Cultures showing growth were identified using standard biochemical procedures and antimicrobial sensitivity was done by Kirby bauer disc diffusion testing. Detection of ESBL production was done as per the CLSI recommendations. Results: A total of 997(57.3%) samples showed growth, out of which 455(26.2%) samples showed growth of gram positive pathogens and in 542(31.1%) Gram-negative bacteria were isolated. Male to female ratio was 0.6: 1, with majority patients having early onset sepsis. Klebsiella pneumoniae was the predominant isolate 358(66.05%). 43.1% of the gram negative isolates showed resistnace against cephalosporins and 37.5% were ESBL producers. Conclusions: Gram negative bacteria are an important cause of early and late-onset neonatal sepsis. Screening for ESBL should be done routinely in all the hospitals to prevent dissemination of these strains within and between hospitals.

Keywords : Bacteraemia, Antimicrobial resistance, Cephalosporins.