Is Superbug imminent? Findings of a retrospective study in Bangladesh.

Background: Emergence of multidrug-resistant (MDR) neonatal sepsis is a potential threat to the survival of newborn babies. Hence, periodic evaluation of the drug resistance organisms responsible for neonatal sepsis is essential for appropriate management and prevention. Objective: This study was conducted to determine the antibiotic-resistant pattern of isolates from blood culture in neonates and their outcome in terms of death. Materials and Methods: This retrospective study was conducted in the neonatal intensive care unit (NICU) of Bangabandhu Sheikh Mujib Medical University from October 2014 to December 2017 for a period of 38 months. During the study period, of 1829 records of admitted patients, 559 cases were found to be suggestive of sepsis. Only blood cultures positive cases were analyzed in this study. Results: Culture-proven sepsis was documented in 124 cases among 559 (22.2%). Majority were late-onset sepsis (LOS), i.e., 113/124 (91.1%); remaining were early onset sepsis (EOS). Acinetobacter (46%) was found to be the most common organism in both early and LOS. Most of the organisms were resistant to 1^st- and 2^nd-line antibiotics. Colistin exhibited the highest sensitivity (91% in EOS and 94% in LOS). The prevalence of MDR and extended drug-resistant (XDR) organisms were 77.4% and 51.6%, respectively. When outcome was compared between nondrug resistance and MDR group, no death was documented among nondrug resistance (P < 0.001). Similarly, death was significantly higher among XDR when compared with nondrug resistance counterpart (P < 0.001). Conclusion: Acinetobacter, Klebsiella, and Escherichia coli are the leading causes of drug-resistant bacterial sepsis in NICU. There is high prevalence of MDR and XDR organisms. Death was significantly higher among MDR and XDR sepsis when outcome was compared with nondrug resistance counterpart. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Neonatology is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)