Frequency of bacteriological agents of early onset sepsis and their antibiotic susceptibility pattern in neonatal intensive care units of University of Lahore teaching hospital & affiliated hospitals, Lahore.

Abstract

Background: In developing countries, early-onset sepsis (EOS) persists as a major cause of neonatal morbidity and mortality. Objectives: This study aimed to find out the frequency of bacteriological agents causing early onset sepsis, their antibiotic sensitivity and resistance patterns. Methods: This cross-sectional study enrolled 84 neonates having early-onset sepsis from the neonatal intensive care units of University of Lahore teaching hospital and affiliated hospitals. Blood culture isolates were evaluated for antibiotic sensitivity and resistance. Chi-square test was used to assess the association between organism and antibiotic sensitivity or resistance, keeping p-value <0.05 as significant. Results: Of the included 84 neonates, males were 59.5% and preterm neonates were 76.2%. Most common isolates were Klebsiella species (35.7%) and Escherichia coli (29.8%). Highest resistance was found for amoxicillin-clavulanic acid, 73 out of 76 isolates (96.1%) and ceftriaxone, 80 out of 84 isolates (95.2%), while lowest resistance was found for meropenem, 9 out of 73 isolates (12.3%) and imipenem 10 out of 73 isolates (13.7%). Sensitivity of linezolid was 100% (n=11) for Staphylococcus aureus and sensitivity of colistin was found in 69 out of 73 isolates (94.5%). Resistance and sensitivity patterns showed significant associations (p<0.05) along with sociodemographic variables. Conclusion: Gram-negative bacteria were most commonly involved in EOS among neonates with high resistance to frequently prescribed antibiotics. Those antibiotics having highest sensitivity like carbapenems and colistin should be considered for empirical treatment. Antimicrobial stewardship programs are urgently required to counter the highest resistance to antibiotics.