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Analysis Study Research Paper | Medical Microbiology | India | Volume 12 Issue 12, December 2023
Changing Pattern of Antibiotic Profile of Gram Negative Blood Stream Infections in NICU in a Tertiary Care Hospital
Dr. Gurpreet Kaur | Dr. Kamaldeep Singh | Dr. Loveena Oberoi [3] | Dr. Tavishi Oberoi [2]
Abstract: Introduction: Blood stream infection is a key determinant of clinical outcomes among patients in neonatal intensive care units. Studies on infections in NICU have reported that Blood Stream Infections, Urinary Tract Infections and Soft Tissue Infections are the common infections in NICU. These infections are commonly caused by Gram negative isolates. These organisms are highly resistant to antibiotics. Early recognition of bacteria and appropriate antimicrobial therapy are essential for controlling infection and preventing the morbidity and mortality. Objectives: To study the profile of Gram negative bacteria causing blood stream infection in patients admitted in neonatal intensive care unit. To know the antibiotic susceptibility pattern of these isolates. Materials and Methods: A total of 2766 blood cultures samples received from Neonatal Intensive Care Unit (NICU) in the hospital, were analyzed. The organisms were identified by Gram staining, cultural characteristics and a battery of biochemical tests. Drug susceptibility was performed on the isolates by Kirby Bauer?s disk diffusion method. Results: Of the 2766 samples, 660 (23.8%) blood cultures were positive. Among 660 positive samples 510 (77.2%) were the Gram negative isolates and 150 were Gram positive (22.8%). The most common isolate was Klebsiella pnuemoniae (45.5%), followed by Pseudomonas aerogenosa (25.9%), Escherichia coli (14.1%), Acinetobacter baumani (12.3%), Citrobacter fruendi (1.4%) and others (Salmonellatyphi & proteus spp). Among Gram negative bacilli low resistance was observed against Imipenem 10 (2. %) followed by Piperacillin - Tazobactam 219 (43%) and Amikacin 189 (37%). High resistance was against Ampicillin 501 (98 %) and Cefipime 364 (71.3%) Conclusion: 1) Appropriate antibiotic utilization in Intensive Care Units is crucial not only in ensuring an optimal outcome but also in preventing multidrug resistant bacteria. 2) De-escalation of the high-end antimicrobials once the sensitivity pattern of the isolate is known is suggested to reduce the antimicrobial pressure. 3) Formulation of hospital antibiotic policy and compliance with existing guidelines will go long way in reducing multi-drug resistance in pathogens.
Keywords: NICU, Gram Negative bacteria, Antibiotic susceptibility pattern
Edition: Volume 12 Issue 12, December 2023,
Pages: 1664 - 1667