Affiliations: Lok Nayak Hospital, New Delhi, India | Vardhman Mahavir Medical College and Safdarjung
Hospital, New Delhi, India
Note: [] Correspondence: Dr. Chellani Harish Kumar, Vardhman Mahavir
Medical College and Safdarjung Hospital, New Delhi, India. Tel.: +91 11
26707520; Fax: +91 9810313072; E-mail: chellaniharish@gmail.com
Abstract: This was a prospective study over one year conducted at the neonatal
unit of a tertiary hospital in North India. Babies with positive
blood/cerebrospinal fluid cultures for Gram-negative bacteria were taken as
study cases. A screening and confirmatory test for
extended-spectrum-β-lactamase (ESBL) detection with antibiotic sensitivity
carried for each isolated organism. 50 out of 102 Gram-negative isolates were
found to be ESBL producers. The most common species isolated were Klebsiella
species (54), of which 37 (68%) were ESBL producers. Other isolates were
Acinetobacter species (2 out producers), E.coli (12/35) and Pseudomonas species
(0/5). Infection with ESBL-producing bacteria was more likely after prolonged
rupture of membranes and previous neonatal treatment with antibiotics. Newborns
with infections with ESBL-producing bacteria were more likely to manifest
lethargy (P=0.04), seizures (P=0.024) and shock (P=0.012) and had a higher
mortality than the non-ESBL group. ESBL-producing bacteria were more likely to
be resistant to other antibiotic classes, especially the aminoglycosides, which
has important implications for the continuing suitability of routine first-line
antibiotic regimens for neonatal sepsis.
Keywords: ESBL, early onset neonatal sepsis, late onset neonatal sepsis, antibiotic resistance
