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

AbstractOBJECTIVE:
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.
AuthorsRajlakshmi Viswanathan, Arun Kumarendu Singh, Sulagna Basu, Suparna Chatterjee, Syamal Sardar, David Isaacs
JournalArchives 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
PMID22155619 (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)

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