NEONATAL SEPSIS

Objective: To find out the bacterial pathogens in neonatal sepsis and todetermine antimicrobial sensitivity patterns of these pathogens. Place and Duration: At the Neonatal Unit of GhurkiTrust Teaching Hospital Lahore, from February 2003 to December 2004. Design: It was an analytical comparativestudy, done in prospective fashion. Subjects and Methods: A total of 100 culture proven neonates of sepsis wereincluded. Clinical data including neonatal and maternal history, physical examination and laboratory data includingblood counts and cultures were recorded. The cases that have already been given antibiotics were excluded. Standarddisc-diffusion method was used to assess the sensitivity pattern for the antibiotics (ampicillin, gentamicin, cefotaxime,ceftazidime, amikacin and imipenem). Results: Out of total of 100 cases, 64 belonged to Early onset Sepsis (EOS)and 36 belonged to Late onset Sepsis (LOS). Gram negative organisms were isolated from more than 80% of thecases. E. Coli was the commonest isolate (n=34), followed by Klebsiella (n=30) and Pseudomonas (n=13), involvingboth early and late onset groups. No isolate of group B streptococci (GBS) was found. Out of 34 isolates ofE.Coli,14.70%(n=5),17.6%(n=6),41.17%(n=14),61.76%(n=21),79.4%(n=27) and 97.05%(n=33) were sensitive toampicillin, gentamicin, cefotaxime, amikacin, ceftazidime and imipenem respectively. Klebsiella and Pseudomonas alsoshowed a low sensitivity to ampicillin, gentamicin, and cefotaxime, while good sensitivity to amikacin, ceftazidime andimipenem. The mortality was significantly high (P<0.05) in low birth weight infants. Conclusion: Improvement inantenatal and natal services is mandatory to reduce incidence of neonatal sepsis and related mortality. Most of theorganisms are resistant to commonly used drugs. Surveillance is required on regular basis.