Pavan Kumar Doniparthi Venkata, Mohan Jesinth, Rakesh P S, Prasad Jasmine, Joseph Lenikumar
Department of Pediatrics, Christian Fellowship Hospital, Dindigul, Tamil Nadu, India.
Department of Pediatrics, Christian Medical College, Vellore, Tamil Nadu, India.
J Family Med Prim Care. 2017 Oct-Dec;6(4):735-738. doi: 10.4103/jfmpc.jfmpc_66_17.
Neonatal sepsis is a leading cause of neonatal mortality and morbidity in the world. The objective of the current study was to detect the common causative microorganisms of neonatal sepsis and their antimicrobial resistance patterns in a rural secondary hospital in Tamil Nadu, India.
Neonates (0-28 days) admitted to this newborn care unit from October 2013 to September 2015, with a diagnosis of probable sepsis were studied. All the enrolled babies had blood cultures taken and were followed up till final outcome, which was discharge or death, irrespective of culture result. Univariate analysis was performed for factors associated with culture positivity, generating odds ratios, and confidence intervals.
Among the 107 babies with a diagnosis of probable sepsis, 28 (26.2%) had shown bacteria in culture. The majority (94.4%) were of early-onset sepsis. The predominant organisms were (10/28) and (6/28). 100% of Gram-negative bacilli and 90% of were resistant to Ampicillin. Gentamicin resistance among Gram-negative bacilli and was 52.9% and 20%, respectively, while third-generation cephalosporin resistance was 31.2% and 20%, respectively. Among the neonates diagnosed as probable sepsis, idiopathic prematurity ( = 0.007) was found to have a statistically significant association with culture-positive sepsis.
The culture positivity rate among the neonates with probable sepsis in the current study was 26%. An alarmingly high degree of antibiotic resistance observed calls for robust infection control practices and an urgent evaluation and development of individual and national antibiotic policies for neonatal sepsis.
新生儿败血症是全球新生儿死亡和发病的主要原因。本研究的目的是在印度泰米尔纳德邦的一家农村二级医院中，检测新生儿败血症的常见致病微生物及其抗菌耐药模式。
对2013年10月至2015年9月入住该新生儿护理单元、诊断为疑似败血症的新生儿（0 - 28天）进行研究。所有纳入的婴儿均进行了血培养，并随访至最终结局，即出院或死亡，无论培养结果如何。对与培养阳性相关的因素进行单因素分析，计算比值比和置信区间。
在107例诊断为疑似败血症的婴儿中，28例（26.2%）血培养显示有细菌。大多数（94.4%）为早发型败血症。主要病原体为（10/28）和（6/28）。100%的革兰氏阴性杆菌和90%的对氨苄西林耐药。革兰氏阴性杆菌和中庆大霉素耐药率分别为52.9%和20%，而第三代头孢菌素耐药率分别为31.2%和20%。在诊断为疑似败血症的新生儿中，特发性早产（= 0.007）与培养阳性败血症有统计学显著关联。
本研究中疑似败血症新生儿的培养阳性率为26%。观察到的抗生素耐药程度高得惊人，这就需要强有力的感染控制措施，以及对新生儿败血症的个体和国家抗生素政策进行紧急评估和制定。
