92

journal of patient safety & infection control 3 ( 2 0 1 5 ) 70117

P058 Prole of organisms causing neonatal

sepsis in tertiary hospitals in New Delhi: A
multicenter prospective cohort study
Suman Chaurasia
All India Institute of Medical sciences, New Delhi,
India
Introduction: There is paucity of reliable information on
neonatal sepsis in developing countries. We sought to study
bacterial etiology of sepsis and determine antimicrobial susceptibilities in inborn neonates in New Delhi.
Method: We prospectively enrolled all neonates admitted in
NICUs in three teaching hospitals. Dedicated research teams
monitored infants daily until discharge/death, and undertook blood/relevant bio-uid culture(s) when suspected of
sepsis. Isolated organisms were identied, tested for antimicrobial susceptibility using CLSI guidelines, and randomly
cross-checked (40% isolates) at another site as part of external
quality control. Final diagnosis of sepsis was assigned based
on clinical course and culture reports.
Result: A total of 15,691 (17.7%) neonates of 88,636 livebirths required NICU admission during study period (July
2011February 2014). Neonatal sepsis occurred in 1941 (14.3%;
95% CI: 13.814.9) cases; 845 (6.2%; 5.86.7) neonates were
diagnosed culture-positive nearly two-thirds before 72 h age
(early onset). Of a total of 1012 isolates, about two-thirds
were gram-negative, including Acinetobacter spp. (21.9%), Klebsiella spp. (16.6%), Escherichia coli (13.7%) and Pseudomonas
spp. (6.7%). Coagulase negative staphylococci (CoNS; 14.9%),
Staphylococcus aureus (12.5%), and Enterococcus spp. (5.7%)
were the predominant gram-positive pathogens. Majority
of pathogens were resistant to commonly used antibiotics. Among the three commonest gram negative isolates,
15.979.2% were carbapenem-resistant and around 19.1%
to 82.3% were multi-drug-resistant. Colistin-resistance was
detected in a total of seven (0.7%) strains. Amongst Staphylococci, methicillin-resistance was common (CoNS: 60.6%
and Staphylococcus aureus: 38.5%); none were resistant to
vancomycin. But, a quarter of Enterococci were vancomycinresistant. Neonates with culture positive sepsis had high
(47.4%) case fatality rate.
Conclusions: Neonatal sepsis continues to be a major morbidity with high case fatality in hospitalized neonates in
tertiary hospitals in New Delhi. Acinetobacter spp. and CoNS
are emerging as dominant pathogens. Appearance of multiand pan-drug resistance is alarming.
Conicts of interest: The author has none to declare.
* Investigators of ICMR Centre for Advanced Research in
Newborn Health:
Safdarjung Hospital (SJH): Aggarwal KC (PI), Deb M (Microbiology PI), Chellani H, Arya S, Gaind R, Kumari V, Charu, John
S, Johny SP, Malhotra A, Philip AS, Rosemol TM, Dhooper M,
Rani N, Kumar A; Maulana Azad Medical College (MAMC): Ramji
S (PI), Prakash K (Microbiology PI), Kumar S, Sharma P, Modi
M, Mor A, Nim JS, Jose D, Thomas M, Varghese B, Singh M,

Sethi M, Kumar A; Chacha Nehru Bal Chikitsalaya (CNBC): Jajoo M

(PI), Manchanda V (Microbiology PI), Dabas V, Deepika, George
J, Sebastian P, Bhutta ZA, Yadav A, Wadhwa A; AIIMS (Nodal
Centre): Paul VK (PI), Deorari AK (PI), Kapil A (Microbiology PI),
Agarwal R, Sankar MJ, Sreenivas V, Saxena M, Thukral A, Gupta
S, Chaurasia S, Mittal D, Agarwal D, Mani K, Suresh SS, Yadav
CP, George A, Sarasan S, Seena KS, Thareja A, Manral N, Lal S,
Thakur V, Meenakshi, Yadav SN; ICMR: Rasaily R, Thavaraj V,
Sinha A.
http://dx.doi.org/10.1016/j.jpsic.2015.10.135

P059 Increase in the hospital purchase of hand

hygiene products: The importance of focusing
on right product
S. Vig, A. Parsad, M. Biswal, N. Dhaliwal, N.
Taneja
Department of Medical Microbiology, PGIMER,
India
Introduction: Alcohol-based hand rub (AHR) consumption
is positively correlated with increase in hand hygiene (HH)
compliance. In our 2000-bedded hospital in India, multiple
awareness drives have been conducted to promote HH. We
wanted to determine the quantitative effect of these campaigns on use of hand hygiene products (soap and AHR) in the
hospital. Over the last six years, bar soap consumption had
increased by 389.15% while that of AHR increased by 146.7%.
Method: Microbiological culture of bar and liquid soaps.
Result: We evaluated microbial contamination of 99 bar soap
and 60 liquid soap samples in our hospital for a year. 61 (61.6%)
of bar soap and 2 (3.3%) liquid soap samples were found to be
contaminated with various organisms.
Conclusions: The focus should be to increase the right kind
of hand hygiene product so that hospitals in developing
countries procure liquid soaps instead of bar soaps in hospitals
for hand washing purposes.
Conicts of interest: The authors have none to declare.
http://dx.doi.org/10.1016/j.jpsic.2015.10.136

P060 Phenotypic detection of metallo-beta

lactamases (MBL) in a resource limited setting:
Is dipicolinic acid better?
M. Gupta 1 , V. Agarwal 1 , R. Surpam 1 , S.
Ughade 2
1

Department of Medical Microbiology, Nagpur,

India
2 Department of Preventive and Social Medicine,
Nagpur, India
Introduction: High carbapenem resistance is a biting reality
so much so an obituary on their death has been written. MBLs
are notorious for causing almost total beta-lactam insusceptibility and are accumulating in bacterial population both in
hospital and environmental settings. There is a denite need