Sudhakar Ajmera1, Vijayalaxmi Ambati2, Akhila Akula3

Of the 130 million babies born worldwide each year, 26 million are born in India alone. Four million babies die with in first 30 days of birth and another four million are stillborn. Newborn mortality represents 40% of all deaths of children less than five years of age. Of the four million deaths each year, nearly 98% occur in developing countries. Globally major causes of neonatal deaths are due to preterm births (28%), sepsis or pneumonia (26%) and birth asphyxia (23%). Neonatal sepsis is one of the commonest causes of neonatal deaths in the developing world accounting to 30-50% of all neonatal deaths per year. The present study is intended to help the practising paediatrician to accurately diagnose the sepsis early using the specific laboratory tests and avert the progression of the disease.
It is an observational cross-sectional study in NICU, Mahatma Gandhi Memorial Hospital. The study was conducted in the period November 2013 to October 2014.
After admission, detailed history and thorough clinical examination was done. Required data was entered in a pre-set proforma and statistical analysis was done. Blood culture was sent. Bacterial culture and sensitivity was checked.
In proven sepsis, 50.25% were Gram-positive, 43.65% were Gram-negative and 6.09% were fungal sepsis Candida). Klebsiella (32.48%) was the most common organism followed by Coagulase positive Staphylococcus (25.38%) and CONS (20.81%). In this study, Gram-negative sepsis was more common in preterm and Gram-positive sepsis was more common in term neonates. Early onset sepsis was the common presentation of proven sepsis, Klebsiella was common organism causing EOS. Whereas CONS was commonest causing late onset sepsis. Among Gram-negative organisms, 58.1% and 27.9% were resistant to cefotaxime and ampicillin+sulbactam respectively. Among Gram-positive isolates, 35% and 22% were resistant to cefotaxime and ampicillin+sulbactam respectively. Klebsiella, most common organism was found to be resistant to cefotaxime (60.9%), ampicillin+sulbactam (32.8%), gentamycin (17%). Resistance of Gram-negative and Gram-positive isolates to first line antibiotics and even with cefotaxime is emerging and is a major concern in neonatal intensive care unit.
The study is of great help to the practising paediatrician and the future scope of the study is very good. The demographic pattern has to be understood and any geographical variation has to be understood.