Study of bacteriological spectrum of neonatal septicemia and associated risk factors of septicemia

The aim of this study was to identify the organisms causing neonatal septicemia and their antimicrobial susceptibility at Neonatal Intensive Care Unit in a tertiary care hospital; to evaluate the maternal and neonatal risk factors and to establish a correlation between the hematological markers and septicemia. This cross sectional study period extends from 1 May to 30 June 2011. 40 neonates suspected to have septicemia or had maternal history of risk factors were enrolled after ethical clearances. A septic work up was carried out in all these infants that included Complete blood counts, C-reactive protein, and blood cultures with antimicrobial sensitivity pattern. The analysis of the peripheral smear was done. Statistical analysis was done by ‘Z’ test. Out of total 40 suspected cases; male: female ratio was found to be 1.6:1.The blood culture was positive in 26(65%) cases, whereas negative in 14(35%). Early onset septicemia was in 27(67.5%) and late onset septicemia was in 13(32.5%). Out of these, 26 positive blood cultures, non-fermenting gram-negative bacilli (65.3%) were found to be the commonest; followed by Pseudomonas species (11.5%); Serratia species (7.69%); Enterococci (3.84%).The organisms showed highest sensitivity to Imipenem and Cefotaxime. The significant risk factors were perinatal maternal fever, prolonged rupture of membranes (>12 hours), Neonatal Resuscitation, Low Birth Weight. Hematological markers TLC<5000 cu.mm and increased CRP were highly indicative of septicemia. As of now, non-fermenters have not been reported to be isolated from the maternal genital tract. This strongly suggests that early onset hospital – acquired sepsis due NFGNB should be an area of concern and future research. But for this, a study on larger sample size is required.