Prevalence of Positive Cultures in Premature Baby Unit at District General Hospital Matara: A Retrospective Study

Abstract

Background: Sepsis is a major cause of morbidity and mortality among babies in premature baby units (PBU). Periodic monitoring of antimicrobial sensitivity of the causative organisms in a particular setting is important for the early management of infections in neonates. Objectives: To determine the proportion of blood culture positivity; to assess the factors associated with sepsis among the babies and to assess the causative microorganisms and their antibiotic susceptibility pattern, isolated in blood cultures of babies with suspected sepsis admitted to PBU at District General Hospital Matara (DGHM) Methods: A retrospective study was conducted in microbiology laboratory of DGHM to review blood culture reports received from PBU. All the consecutive samples of PBU from 31st December 2022 until 01st January 2021 were taken into study. Culture isolates, antibiotic susceptibility patterns and other related data were collected and analyzed using Microsoft Excel and SPSS version 25.0. Results: A total of 1612 blood culture reports were included in the study. Overall blood culture positivity was 9% (n=154). Among the positive cultures 125 (81.2%) isolates were bacteria, 3 (1.9%) were Candida spp. and the rest of the growth was considered as contaminants. Among bacterial isolates, 65.6% were gram positive cocci and 34.4% were gram negative bacilli. Common isolated organisms were coagulase-negative Staphylococci (51.6%), LF coliforms (11.2%), Pseudomonas spp. (8%), Staphylococcus aureus (7.2%), Streptococcus spp. (6.4%) and NLF coliforms (5.6%). Among gram negative organisms, 7% were Extended Spectrum Beta Lactamase produces, 4.7% were multi drug resistant and carbapenem resistance was seen in 40.5% of organisms. Among Staphylococcus isolates, 55.6% were Methicillin Resistant Staphylococcus aureus. Prematurity (p=0.017), low birth weight (p=0.002) were significantly associated with culture positive sepsis. Conclusions:. Coagulase-negative Staphylococci, LF coliform, and Pseudomonas spp. were the predominant causative organisms. Ciprofloxacin and aminoglycosides were the most effective drugs against gram positive and negative bacteria.