Multi-drug resistant gram negative bacilli causing early neonatal sepsis in India.

Abstract

OBJECTIVE:

To study the organisms causing early and late onset neonatal sepsis, with special reference to multi-drug resistant gram negative bacilli, at two neonatal units (one urban, one rural) in India.

METHODS:

Prospective surveillance study.

RESULTS:

There were 159 episodes of sepsis (81 urban and 77 rural) affecting 158 babies. Gram negative bacilli caused 117 infections (68%) and predominated at both centres in both early and late sepsis. Klebsiella pneumoniae was the commonest organism, causing 61 infections (38.3%). In early sepsis (0-2 days), non-fermenting gram negative bacilli caused 42.1% of infections at the urban centre; there were no cases of early Group B Streptococcus sepsis. Late onset sepsis was mainly caused by gram negative bacilli at both centres. Multi-drug resistance of over 80% of early-onset gram negative organisms to ampicillin, third generation cephalosporins and gentamicin indicates that these multi-resistant organisms are almost certainly circulating widely in the community. The overall mortality from early sepsis was 27.3% (9 of 33) and from late sepsis was 26.2% (33 of 126). Gram negative bacilli caused all deaths from early sepsis and 87.5% of deaths from late sepsis.

CONCLUSION:

This study shows that multi-drug resistant gram negative bacilli are a major cause of early and late neonatal sepsis in India and are almost certainly widespread in the community.

• Authors: Rajlakshmi Viswanathan, Arun Kumarendu Singh, Sulagna Basu, Suparna Chatterjee, Syamal Sardar, David Isaacs
• Journal: Archives of disease in childhood. Fetal and neonatal edition (Arch Dis Child Fetal Neonatal Ed) Vol. 97 Issue 3 Pg. F182-7 (May 2012) ISSN: 1468-2052 [Electronic] England
• PMID: 22155619 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents

Topics

• Age Factors
• Anti-Bacterial Agents (therapeutic use)
• Birth Weight
• Drug Resistance, Multiple, Bacterial
• Gestational Age
• Gram-Negative Bacteria (drug effects)
• Gram-Negative Bacterial Infections (drug therapy, epidemiology, microbiology)
• Humans
• Incidence
• India (epidemiology)
• Infant, Newborn
• Intensive Care Units, Neonatal
• Prospective Studies
• Rural Health (statistics & numerical data)
• Sepsis (epidemiology, microbiology)
• Urban Health (statistics & numerical data)