DOI: http://dx.doi.org/10.18203/2349-3933.ijam20171995

Drug resistance pattern analysis of various organisms isolated from neonatal intensive care unit of a tertiary care hospital in Odisha, India

Kausik Kumar Sarangi, Dipti Pattnaik, Surya Narayan Mishra, Manas Kumar Nayak, Jagadananda Jena

Abstract


Background: Neonatal septicaemia is characterized by systemic signs and symptoms of generalized bacteraemia with a positive blood culture in the first four weeks of life. This study was designed to detect Multi Drug Resistant pattern from organisms in neonatal septicaemic cases. The aim of the study is to find the antibiotic sensitivity pattern and drug resistance pattern (ESBL, MBL, Carbapenemase, AmpC β-lactamase, MRSA) among the organisms isolated.  

Methods: This prospective study was carried out in the Department of Microbiology in association with Dept. of Paediatrics and NICU, of Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India during the period from November 2012 - April 2014. The study was conducted on 250 patients. The inclusion criteria are neonates with suspected septicaemia, admitted to NICU, of KIMS, Bhubaneswar, Odisha, India. Two ml of venous blood from each neonate was collected & cultured by automated method. Phenotypic confirmatory tests for ESBL production and MBL detection was done as per CLSI guideline. MRSA detection was done by Cefoxitin disk (30 mcg) screen test.  

Results: All gram positive pathogenic isolates were sensitive to Linezolid, Tigecycline and Vancomycin. Maximum resistance was seen against Benzylpenicilin and Ampicillin. Among the gram-negative isolates maximum antibiotic sensitivity was observed for Tigecycline, Levofloxacin and amikacin & resistance was maximum for cefadroxil and Ampicilin. Among the gram negative bacterial pathogens ESBL production was maximum by E.coli (75%) and Burkholderia cepacia (75%) followed by Enterobacter cloacae (66.7%) and Acinetobacter iwoffi (50%). Metallo- beta- lactamase production was seen maximum in Acinetobacter iwoffi (100%) followed by Burkholderia cepacia (75%). Methicillin resistance was seen maximum by S. epidermidis (58.3%) followed by S. haemolyticus, S. aereus, S. warneri and S. hominis.

Conclusions: This study facilitated the screening of MRSA, ESBL and MBL producing pathogens which are an emerging problem. Long term surveillance is needed to combat this emerging global challenge.


Keywords


Drug resistance, ESBL, MBL, MRSA, Neonatal sepsis

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References


Bhalchandra MH, Ghogare H, Wyawahare A, Mulay VM, Bansal VP, Bansal MP. Clinical and microbiological profile of neonatal sepsis at tertiary care hospital, Aurangabad, Maharashtra. National J Med Sci. 2012;1(2):32-9.

Wayne PA. Principles and procedures for blood cultures; approved guideline, CLSI document M47-A. Clinical and Laboratory Standards Institute (CLSI). 2012.

Jain A1, Roy I, Gupta MK, Kumar M, Agarwal SK. Prevalence of extended-spectrum β lactamase producing Gram-negative bacteria in septicaemic neonates in a tertiary care hospital. J Med Microbiol. 2003;52(5):421-5.

Roy S, Gaind R, Chellani H, Mohanty S, Datta S, Singh AK, Basu S. Neonatal septicaemia caused by diverse clones of Klebsiella pneumoniae and Escherichia coli harbouring blaCTX-M-15. Indian J Med Res. 2013;137(4):791.

Gandhi S, Ranjan KP, Ranjan N, Sapre N, Masani M. Incidence of neonatal sepsis in tertiary care hospital: An overview. Int J Med Sci Public Health. 2013;2(3):548-52.

Franklin C, Liolios L. Phenotypic Detection of Carbapenem-Susceptibl Metallo-Lactamase-Producing Gram-Negative Bacilli in the Clinical Laboratory. J Clin Microbiol. 2006;44(9):3139-44.

Motara F, Ballot DE, Perovic O. Epidemiology of neonatal sepsis at Johannesburg Hospital. Southern African J Epidemiol Infection. 2005;20(3):90-3.

Saxena S, Banerjee G, Singh M, Tripathi P. Detection of MecA genes and antibiotic susceptibility pattern of cogulase negative staphylococci in neonatal intensive care unit of tertiary care hospitals. AJRC. 2013;2325-4076.

Kamble A, Nagarathnamma T, Asha B. Neonatal septicaemia bacteriological profile and antibiogram with special reference to drug resistance. IJRSR. 2014;5(2):522-6.

Shahid M. Malik A, Agrawal M Singhal S. Phenotypic detection of extended-spectrum and AmpC β-lactamases by a new spot-inoculation method and modified three-dimensional extract test: comparison with the conventional three-dimensional extract test. J Antimicrob Chemother. 2004;54(3):684-7.