P2-453 Neonatal septicaemia in India: major cause of morbidity & mortality and challenge for health professionals

Introduction Neonatal septicaemia is life-threatening emergency that demands urgent management and leading cause of neonatal mortality accounting nearly half of all neonatal deaths . Blood culture is gold standard method for diagnosis but changing pattern of organisms and frequent emergence of resistant bacteria causes difficulty in treatment. Non-specificity of symptoms creates difficulty in diagnosis of infections in the early stage. Present study was conducted with the objectives of isolation of bacteria from blood, their sensitivity and resistance pattern, correlation of maternal and fetal risk factors. Methods Study was conducted in tertiary care centre on 210 cases of clinically diagnosed neonatal septicaemia admitted in NICU. Blood culture was done in all cases by conventional three subculture method and antibiotic sensitivity was done by Kirby Bauer disc diffusion. All cases were studied for maternal & fetal risk factors. Results Blood culture was positive in 49.05% cases. Klebsiella Pneumoniae was frequently isolated pathogen (63.11%), followed by Escherichia coli (12.62%) and Staphylococcus aureus (10.68%). Gram negative isolates from enterobactericeae were 100% sensitive to imipenem followed by amikacin and cefotaxime. S aureus isolates were 100% sensitive to vancomycin followed by amikacin and cloxacillin. The commonest maternal risk factors were muconium stained amniotic fluid (42.72%), premature rupture of membrane (33%), History of fever (20.39%). Fetal risk factors commonly present were 79.61% low birth weight, 67.96% neonates were preterm and birth asphyxia (65.05%). Conclusion There is a need of continuous surveillance of the bacteriological profile and antimicrobial sensitivity pattern of neonatal septicaemia in each and every NICU.