ABSTRACT Background: Neonatal sepsis remains a leading cause of morbidity and mortality, especially in preterm and very low birth weight infants. Increasing antimicrobial resistance and delays associated with conventional culture methods hinder timely treatment. This study aimed to evaluate the local epidemiology of neonatal sepsis, antimicrobial susceptibility patterns, and the diagnostic utility of 16S and 18S rRNA polymerase chain reaction (PCR) from overnight-incubated blood broth. Methods: A prospective study was conducted on 383 neonates with suspected sepsis admitted to the neonatal intensive care unit (NICU) of a tertiary care hospital in North India. Blood samples were processed using the BACT/ALERT system. Identification and susceptibility testing were done using Kirby-Bauer disk diffusion and VITEK 2. PCR targeting 16S (bacterial) and 18S (fungal) rRNA genes was performed on DNA extracted from overnight-incubated blood broth. Results: Out of 383 samples, 199 (51.96%) were culture positive; 185 were confirmed as true infections. Gram-positive bacteria (37.3%) were most common, followed by fungi (34.05%) and Gram-negative organisms (28.65%). Coagulase-negative Staphylococcus was the most frequent Gram-positive isolate; Klebsiella pneumoniae and Acinetobacter baumannii were dominant among Gram negatives. High levels of multidrug resistance were noted, particularly among Gram-negative and non-albicans candida species. The 16S rRNA PCR showed 80.33% sensitivity and 100% specificity (Cohen’s κ = 0.845). The 18S rRNA PCR had 57.14% sensitivity and 100% specificity (Cohen’s κ = 0.689). Conclusion: Multidrug-resistant organisms dominate neonatal sepsis in this setting. Despite lower sensitivity for fungal detection, PCR from overnight blood broth serves as a rapid and reliable adjunct to culture in NICU diagnostics.
Singh et al. (Tue,) studied this question.