Emerging Trend of Multidrug-resistant Organisms Causing Sepsis in Ventilated Newborns.

INTRODUCTION

Increasing trend of antibiotic and multidrug resistance (MDR) organism are significant public health risks and major issues in intensive care unit (ICU). We aimed to identify, determine the prevalence, and to evaluate their antibiotic resistance pattern in sepsis-positive ventilated newborns.

MATERIALS AND METHODS

The observational cross-sectional study was conducted in a neonatal ICU. One hundred and sixty-eight neonates were included.

RESULTS

One hundred and sixty-eight ventilated newborns were enrolled, of which 79 (47.02%) cases were culture positive. Of the isolated organisms, 53 (67.08%) were MDR, in which 32 (60.03%) with early-onset neonatal sepsis (EONS) and 21 (39.6%) with late-onset neonatal sepsis. Twenty-three (43.39%) isolated organisms were Gram-positive MDR and 30 (56.6%) were Gram-negative MDR. The most common isolated MDR organisms were Pseudomonas aeruginosa and coagulase-negative staphylococci (CONS). The culture positivity of the MDR organism was significantly higher to non-MDR ( P < 0.000017). Among gram negative MDR organism Pseudomonas and Klebsiella was highly resistant against ciprofloxacin and piperacillin with tazobactam respectively. Among MDR Gram-positive bacteria CONS and Enterococcus faecalis was most common. CONS were highly resistant to clindamycin, penicillin, and ciprofloxacin.

CONCLUSIONS

This study showed an alarmingly high prevalence of MDR organisms and Gram-negative strains which were more isolated from EONS. This can limit the initial therapeutic choice regarding antibiotics, leading to increased mortality, morbidity with risk of spreading resistant organisms.