Antimicrobial Resistance among Neonates with Bacterial Sepsis and Their Clinical Outcomes in a Tertiary Hospital in Kathmandu Valley, Nepal

• Main Authors: Bijendra Raj Raghubanshi, Karuna D. Sagili, Wai Wai Han, Henish Shakya, Priyanka Shrestha, Srinath Satyanarayana, Bal Man Singh Karki
• Format: Article
• Language: English
• Published: MDPI AG 2021-04-01
• Series: Tropical Medicine and Infectious Disease
• Subjects: antimicrobials; culture and drug sensitivity test; culture-confirmed sepsis; neonatal sepsis; antimicrobial resistance; LAMA
• Online Access: https://www.mdpi.com/2414-6366/6/2/56

Globally, antibiotic resistance in bacteria isolated from neonatal sepsis is increasing. In this cross-sectional study conducted at a medical college teaching hospital in Nepal, we assessed the antibiotic resistance levels in bacteria cultured from neonates with sepsis and their in-hospital treatment outcomes. We extracted data of neonates with sepsis admitted for in-patient care from June 2018 to December 2019 by reviewing hospital records of the neonatal intensive care unit and microbiology department. A total of 308 neonates with sepsis were admitted of which, blood bacterial culture antibiotic sensitivity reports were available for 298 neonates. Twenty neonates (7%) had bacteriologic culture-confirmed neonatal sepsis. The most common bacterial species isolated were <i>Staphylococcus aureus</i> (8), followed by coagulase-negative <i>Staphylococcus</i> (5). Most of these bacteria were resistant to at least one first-line antibiotic used to manage neonatal sepsis. Overall, there were 7 (2%) deaths among the 308 neonates (none of them from the bacterial culture-positive group), and 53 (17%) neonates had left the hospital against medical advice (LAMA). Improving hospital procedures to isolate bacteria in neonates with sepsis, undertaking measures to prevent the spread of antibiotic-resistant bacteria, and addressing LAMA’s reasons are urgently needed.