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A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
08:46

A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis

Published on: August 12, 2020

Extended-spectrum beta-lactamase-producing Gram-negative bacteria causing neonatal sepsis in India in rural and urban

Dinesh S Chandel1,2, Judith A Johnson3, Rama Chaudhry4

  • 1Asian Institute of Public Health, Bhubaneswar, Orissa, India.

Journal of Medical Microbiology
|December 25, 2010
PubMed

Insights

Extended-spectrum β-lactamase (ESBL)-producing Gram-negative bacilli are a growing concern in Indian neonatal sepsis. Over a third of these bacteria are ESBL producers, showing resistance to common antibiotics but remaining susceptible to imipenem.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Neonatal Health

Background:

  • Extended-spectrum β-lactamase (ESBL)-producing Gram-negative bacilli (GNB) pose a significant global health threat.
  • Neonatal sepsis remains a leading cause of mortality in India, with limited microbiological data available for community-acquired cases.

Purpose of the Study:

  • To investigate the microbiological characteristics of Gram-negative bacilli causing neonatal sepsis in India.
  • To determine the prevalence and antimicrobial susceptibility of ESBL-producing GNB in Indian neonates.
  • To analyze the clonal relatedness of ESBL-producing GNB strains.

Main Methods:

  • A population-based study involving 1738 infants diagnosed with clinical sepsis across four Indian centers.
  • Blood cultures were performed, and bacterial isolates were identified using API tests.
  • Antimicrobial susceptibility testing, ESBL phenotyping, and pulsed-field gel electrophoresis (PFGE) were conducted on 155 GNB isolates.

Main Results:

  • Klebsiella species and Escherichia coli were the most common GNB pathogens causing neonatal sepsis.
  • Over one-third of GNB isolates were identified as ESBL producers in both community and hospital settings.
  • ESBL producers frequently exhibited co-resistance to aminoglycosides and ciprofloxacin but remained susceptible to imipenem. PFGE revealed genetic diversity, with three main profiles (PFP I-III) accounting for over 40% of isolates, including a common clone found in geographically distant locations.

Conclusions:

  • ESBL-producing Klebsiella species and E. coli are prevalent causes of neonatal sepsis in India.
  • The presence of ESBL-producing strains in community-acquired infections, even without prior antibiotic exposure, necessitates increased vigilance.
  • Further research into the ecology of these organisms is crucial for effective management and control strategies.

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