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VOLUME 4 , ISSUE 1 ( January-March, 2025 ) > List of Articles

ORIGINAL RESEARCH

Evaluation of Neonatal Infections in the NICU over a 10-year Period

Pooja Shah, Sabrina K Malik, Juhi Motiani, Tara Lozy, Sejal Bhavsar

Keywords : Antibiotic use practices, Infection, Neonate, Neonatal intensive care unit, Newborn, Organism susceptibility

Citation Information : Shah P, Malik SK, Motiani J, Lozy T, Bhavsar S. Evaluation of Neonatal Infections in the NICU over a 10-year Period. 2025; 4 (1):6-12.

DOI: 10.5005/jp-journals-11002-0115

License: CC BY-NC 4.0

Published Online: 25-03-2025

Copyright Statement:  Copyright © 2025; The Author(s).


Abstract

Background: Bacterial infections are a leading cause of morbidity and mortality in premature and critically ill neonates. In this quality-improvement (QI) study, we sought to characterize the bacterial infections in our neonatal intensive care unit (NICU). Aim: Our aim was to determine whether the spectrum of bacteria causing neonatal sepsis and their antibiotic susceptibility was changing over time. This information is essential for optimizing the empirical antibiotic treatment protocols needed for treating suspected sepsis prior to identification of the bacterial isolates. Materials and methods: We retrospectively reviewed the medical records of all infants treated for culture-positive sepsis in our NICU over the last 10 years. Results: We identified 151 culture-positive bacterial sepsis events in 125 infants. The organisms isolated each year largely remained similar throughout the study. Early-onset sepsis (EOS) was caused most frequently by Escherichia coli (E. coli) and group B Streptococcus, whereas the leading causes of late-onset sepsis (LOS) were coagulase-negative Staphylococcus (CoNS) and methicillin-sensitive Staphylococcus aureus. We are also seeing a trend for increasing Klebsiella isolates since 2015. Conclusion: There was no significant shift in organisms causing neonatal infections during the last 10-years. We need to carefully follow the number of Klebsiella spp. isolates and also record the antibiotic sensitivity profiles of E. coli over time. Clinical significance: In our NICU, the bacterial isolates and antibiotic susceptibility patterns have not shown major changes in recent years. Hence, the empirical antibiotic protocols for suspected sepsis do not need to be revised right now. We do need to monitor the number and antibiotic sensitivity of certain Gram-negative bacterial isolates. Our antibiotic protocols will need fine adjustment to cover the most frequently isolated bacteria for good outcomes, but also to avoid overuse and secondary resistance.

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