Culture Positive Neonatal Sepsis - A Retrospective Analysis of Clinical Profile, Microbial Pattern and Outcome in a Tertiary NICU in Chennai
DOI:
https://doi.org/10.65129/medical.v1i1.19Keywords:
Antibiotic Resistance, Culture-positive, Klebsiella pneumoniae, Mortality, Neonatal Sepsis, Preterm InfantsAbstract
Background: Neonatal sepsis continues to be a leading cause of morbidity and mortality, particularly in preterm and low birth weight infants. The spectrum of organisms and their resistance patterns vary across centres, making local data essential to guide management. Aim: To describe the clinical profile, microbial pattern and outcomes of culture-positive neonatal sepsis in a tertiary NICU in Chennai. Methodology: This retrospective study included all neonates with positive blood cultures admitted to the NICU of Government RSRM Lying-In Hospital, Stanley Medical College, between January and December 2024. Demographic data, risk factors, clinical features, organism profile, antibiotic sensitivity, hospital stay and outcomes were analysed. Results: In this study 68 neonates were studied, of whom 57.4% were male. Nearly 80% were preterm and more than 80% had a birth weight below 2.5 kg. Late-onset sepsis was more frequent (61.8%) than early-onset sepsis (38.2%). Klebsiella pneumoniae (22.1%) and Acinetobacter baumannii (16.2%) were the most common Gram-negative isolates, while Enterococcus faecalis (16.2%) and Staphylococcus haemolyticus (13.2%) were the predominant Gram-positives. Gram-negatives showed high resistance to first-line agents; carbapenems and colistin were the most effective, whereas vancomycin and linezolid were reliable against Gram-positives. The mean hospital stay was 14.2 ± 6.5 days (EOS: 11.6 ± 5.2; LOS: 15.8 ± 7.4). Overall mortality was 16.2%, with higher fatality in multidrug-resistant Gram-negative and fungal infections. Conclusion: Culture-positive neonatal sepsis in our unit was closely linked to prematurity, low birth weight and invasive procedures. Gram-negative organisms predominated and contributed to most deaths, highlighting the need for updated local antibiograms, infection-control bundles and strict antibiotic stewardship to improve outcomes in this vulnerable population.
Downloads
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Journal of Medical and Medical Specialities

This work is licensed under a Creative Commons Attribution 4.0 International License.
References
1. Milton R, Gillespie D, Dyer C, et al. Neonatal sepsis and mortality in low-income and middle-income countries from a facility-based birth cohort: an international multisite prospective observational study. Lancet Glob Health. 2022; 10(5):e661-e672. PMID: 35427523. PMCID: PMC9023753.https://doi.org/10.1016/S2214-109X(22)00043-2
2. Mu C, et al. Global burden and trends of neonatal infections, 1990-2021: A systematic analysis. Lancet Child Adolesc Health. 2023; 7(6).
3. Singh M, Alsaleem M, Gray CP. Neonatal Sepsis. Stat Pearls. Stat Pearls Publishing; 2022.
4. Dramowski A, Bolton L, Fitzgerald F, Bekker A. Neonatal sepsis in low- and middle-income countries: Current challenges and future opportunities. Pediatr Infect Dis J. 2025; 44(6):e207-e210. PMCID: PMC7617557. PMID: 40168607. https://doi.org/10.1097/INF.0000000000004815
5. Kariniotaki C, Thomou C, Gkentzi D, et al. Neonatal sepsis: A comprehensive review. Antibiotics. 2024; 14(1):6. PMID: 39858292. PMCID: PMC11761862. https://doi.org/10.3390/antibiotics14010006
6. Dong Y, Speer CP. The role of Staphylococcus epidermidis in neonatal sepsis: Guarding angel or pathogenic villain? Int J Med Microbiol. 2014; 304(5-6):513-520. https://doi.org/10.1016/j.ijmm.2014.04.013
7. Howard A, O’Donoghue M, Feeney A, Sleator RD. Acinetobacter baumannii: An emerging opportunistic pathogen. Virulence. 2012; 3(3):243-250. PMID: 22546906. PMCID: PMC3442836. https://doi.org/10.4161/viru.19700
8. Moftian N, Soltani TS, Mirnia K, et al. Clinical risk factors for early-onset sepsis in neonates: A prospective cohort study. Iran J Med Sci. 2023; 48(1):57-69. PMCID: PMC9843461. PMID: 36688195. https://doi.org/10.30476/IJMS.2022.92284.2352
9. Chen X, Qiu X, Wei J, Huang Y, Yang Y, Pan Y, et al. Risk factors for and outcomes of early-onset neonatal bloodstream infections: A 7-year multicentre retrospective study. BMC Infect Dis. 2023; 23:780.
10. World Health Organization. Managing possible serious bacterial infection in young infants when referral is not feasible. WHO; 2015.
11. Weiss SL, Peters MJ, Alhazzani W, Agus MSD, Flori HR, Inwald DP, et al. Surviving sepsis campaign international guidelines for the management of septic shock and sepsisassociated organ dysfunction in children. Intensive Care Med. 2020; 46(Suppl 1):10-67. PMID: 32030529. PMCID: PMC7095013. https://doi.org/10.1007/s00134-01905878-6.
12. National Neonatal-Perinatal Database (NNPD). Report for 2021-22. Indian Council of Medical Research and National Neonatology Forum; 2022.
13. Sharma D, Kaur A, Farahbakhsh N, Agarwal S. Current perspectives of neonatal sepsis in India: A review. J Matern Fetal Neonatal Med. 2020; 33(20):3501-3512. https://doi.org/10.1080/14767058.2019.1572735
14. Pawar A, Bansal A, Patel D, Gupta S, Natarajan G. Microbial profile and antimicrobial resistance in culture-positive neonatal sepsis: experience from a tertiary care NICU in South India. Indian J Pediatr. 2022; 89(6):547-554.
15. Patel DV, Patel DV, Patel DV, et al. Clinical profile of neonatal sepsis in Western India with special reference to microbial etiology. J Clin Neonatol. 2021; 10(3):214-220.
16. Gandra S, Kotwani A, Bazzani L, et al. Scoping report on antimicrobial resistance in India. WHO; 2021.
17. Chaurasia S, Sankar MJ, Agarwal R, et al. Neonatal sepsis in South Asia: Huge burden and spiralling antimicrobial resistance. BMJ. 2019; 364:k5314. https://doi.org/10.1136/bmj.k5314
18. Kumaravel KS, Anitha M, Rajendran R, et al. Antimicrobial resistance patterns in Gram-negative neonatal sepsis: Experience from a NICU in Tamil Nadu, India. J Trop Pediatr. 2023; 69(3).
19. Indian Council of Medical Research (ICMR). Annual report of the antimicrobial resistance surveillance network 2019-2022. ICMR; 2022.
